Healthcare Access and its Determinants among Elderly Individuals Living Alone in Rural India: A Cross-Sectional Study

Background Elderly individuals living alone constitute a vulnerable subgroup, often lacking family support for daily needs and healthcare. Despite national initiatives for geriatric care in India, little is known about their access to health services and functional support needs. This study assessed healthcare access, related barriers, and daily life management needs among elderly individuals living alone in rural India. Methods A community-based cross-sectional study was conducted in the Wardha block, Maharashtra, from August to September 2024. A total of 400 elderly individuals aged ≥60 years, living alone or only with a spouse, were selected using simple random sampling from a demographic surveillance database. Data were collected through a pretested semi-structured questionnaire covering sociodemographic details, healthcare access, barriers, and daily life management needs. Descriptive statistics summarizing participant characteristics and reported barriers. Healthcare access was examined as the dependent variable, and predictors were assessed via logistic regression. Results Among the 400 participants, the majority were aged above 70 years (61%) and men (65%). Most (94%) reported perceived access to a nearby healthcare facility, yet barriers persisted: transportation difficulties (33%), financial constraints (17%), and long waiting times (21%) were frequently cited. Nearly three-fourths (74%) reported at least one chronic illness. The functional assessment revealed independence in most basic activities of daily living, although dependence was greater for instrumental tasks such as cooking (33%), shopping (31%), and managing finances (44%). In multivariable logistic regression, the availability of free healthcare services (AOR 8.25, 95% CI: 2.56–26.60) significantly increased the likelihood of perceived access, whereas having a chronic illness (AOR 0.26, 95% CI: 0.08–0.81) and inadequate consultation time (AOR 0.20, 95% CI: 0.002–0.199) were associated with reduced access. Conclusions Elderly individuals living alone face distinct challenges in accessing healthcare, shaped not only by service availability but also by financial, functional, and social barriers. Strengthening financial protection, facilitating transport, and embedding community-based caregiving within national programmes will be critical to ensure that this vulnerable group is not left behind in the pursuit of universal health coverage.