Concepts of Long-Term Care (LTC) Financing Among the Older Adults in Ghana Based on Andersen Behavioral Model

Concepts of Long-Term Care (LTC) Financing Among the Older Adults in Ghana Based on Andersen Behavioral Model | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Concepts of Long-Term Care (LTC) Financing Among the Older Adults in Ghana Based on Andersen Behavioral Model Daniel Offei This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7171205/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Introduction In Ghana, ongoing social transformations are gradually eroding the traditional dependence on family members for the care of older adults. Although a formal long-term care (LTC) system has yet to be fully established, older adults are increasingly faced with a range of LTC financing options. This study seeks to explore the financial dimensions of care for older adults and identify the factors that influence the adoption of various LTC funding models. Methods The study utilized data from Wave 3 of the Ghana Socio-Economic Panel Survey (GSPS). Multiple and binary logistic regression models were employed to analyze the data, guided by the Andersen Behavioral Model of Health Services Use. This framework categorizes influencing factors into predisposing, enabling, and need-related domains. Results Compared to individuals without care financing, the odds of combined care financing were higher among adults aged 80+, females, contributors to farm or non-farm businesses, wealthy individuals, household heads and those with disabilities in two Activities of Daily Living (ADLs). Frequent alcohol consumers were more likely to use informal care financing but less likely to use formal care. The availability of health facilities increased the odds of formal care use, while individuals holding traditional office positions were less likely to use formal care. Gender-stratified models showed that female participants involved in non-farm and farm businesses, and those who frequently consumed alcohol, were more likely to use informal care financing. Female Christians were more likely to rely on formal care financing. Conclusion These findings offer insights for designing targeted LTC financing options to meet the diverse needs of older adults in Ghana. Long-Term Care LTC Financing Andersen Behavioral Model Older Adults Ghana Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementaryMaterialDOffei.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 20 Sep, 2025 Editor invited by journal 24 Jul, 2025 Editor assigned by journal 24 Jul, 2025 Submission checks completed at journal 24 Jul, 2025 First submitted to journal 20 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7171205","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":491997586,"identity":"ecb058b5-cc2b-47f6-ae30-5bc13be51aef","order_by":0,"name":"Daniel Offei","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6ElEQVRIie2QsQrCMBCGEw6uS9C1RcVXKHSvr9LQVVyEgnQQKZyjj+BbZC8F3ZwFB1t9gg5C3UyLi0tbN8F8w0GO/yN3x5jB8ItAmrMAGUMGm1y/xaBTwdB9KzxxawV7KayJcbKbRpcxROB5HvmLgbWh1WPuj/WExe3cojgE4AancIkipctEhXow9Lx5i+JedwdbEkjS9eIo0IrAUatyAKuStJY0LWjpqHUvBZmkTP/CiZcq61bqXezgdJQkZDLi6igQOnapL1ZWUSz32ywtnyqeDa2kuLcpH4Boat94Da++SRsMBsPf8AIk1kIVK1AZbwAAAABJRU5ErkJggg==","orcid":"","institution":"Central University","correspondingAuthor":true,"prefix":"","firstName":"Daniel","middleName":"","lastName":"Offei","suffix":""}],"badges":[],"createdAt":"2025-07-20 17:38:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7171205/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7171205/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":88327492,"identity":"dca8d9d8-7eb5-4c80-a5eb-d1013a5ec7bf","added_by":"auto","created_at":"2025-08-05 10:07:39","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":569156,"visible":true,"origin":"","legend":"","description":"","filename":"DoffeiPaperConceptsofLTCFinancing.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7171205/v1_covered_5b3ae887-32bb-4a0e-80e1-5e25d9d53f97.pdf"},{"id":88325873,"identity":"f2b7456b-5e38-49b5-8c7f-af21ff063878","added_by":"auto","created_at":"2025-08-05 09:43:37","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":56998,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryMaterialDOffei.docx","url":"https://assets-eu.researchsquare.com/files/rs-7171205/v1/704b3d7f12db4057ffdc7556.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Concepts of Long-Term Care (LTC) Financing Among the Older Adults in Ghana Based on Andersen Behavioral Model","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Long-Term Care, LTC Financing, Andersen Behavioral Model, Older Adults, Ghana","lastPublishedDoi":"10.21203/rs.3.rs-7171205/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7171205/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn Ghana, ongoing social transformations are gradually eroding the traditional dependence on family members for the care of older adults. Although a formal long-term care (LTC) system has yet to be fully established, older adults are increasingly faced with a range of LTC financing options. This study seeks to explore the financial dimensions of care for older adults and identify the factors that influence the adoption of various LTC funding models.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study utilized data from Wave 3 of the Ghana Socio-Economic Panel Survey (GSPS). Multiple and binary logistic regression models were employed to analyze the data, guided by the Andersen Behavioral Model of Health Services Use. 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