Educational Attainment and Healthcare Utilization Among Adults with Multimorbidity in India: A Cross-Sectional Analysis of LASI Wave-1 Data

Background Multimorbidity, the coexistence of two or more chronic health conditions, is an emerging public health concern worldwide. In India, while the burden among older adults is becoming clearer, little is known about how education influences healthcare utilization in this population. The aim is to explore the association between educational attainment and healthcare utilization among older adults with multimorbidity in India. Methods We analysed data from Wave 1 (2017–2018) of the Longitudinal Ageing Study in India (LASI-1), including 71,130 participants aged 45 years and above. Multimorbidity was identified through self-reported physician diagnoses. Descriptive and multivariable logistic regression analyses were conducted to assess associations between education and healthcare type (public, private, or none), controlling for sociodemographic and behavioural factors. Results Multimorbidity was present in 15.6% of participants, most frequently involving hypertension (26.2%) and diabetes (11.4%). Its prevalence increased with age, was higher in urban areas (23.3%) than rural areas (12.2%), and was more common among wealthier and more educated individuals. In terms of healthcare use, 45.5% relied on private facilities, 34.3% did not seek formal care, and 20.2% used public services. Higher education was associated with lower use (AOR: 0.51, 95% CI: 0.39–0.65, p < 0.001) of public facilities and greater reliance on private care (AOR = 0.79, 95% CI: 0.65–0.98, p = 0.035). The findings highlight significant socioeconomic (AOR:2.56, 95% CI: 2.10–3.12, p < 0.001) and geographic inequalities (highest use of private facility in East, AOR: 5.05, 95% CI: 3.83–6.66, p < 0.001 and highest use of public facility in North, AOR: 2.77, 95% CI: 1.96–3.92, p < 0.001) in the burden of multimorbidity and access to healthcare, underscoring the need for targeted policies to improve equitable care. Conclusion Educational attainment substantially shapes healthcare-seeking behavior among older adults with multimorbidity in India. Policies ensuring equitable, high-quality care are needed to address these disparities.