Risk of Exclusion of Older Adults from Access to Medical Services: Findings from a Study Conducted in Eastern Poland
Purpose: This article presents the findings of original empirical research aimed at diagnosing the level of access to selected medical services among older adults residing in Eastern Poland. The analysis made it possible to identify the factors limiting the use of these services, to determine the frequency of their utilisation by older adults, and to assess the organisation and accessibility of medical care. The results obtained point to significant barriers in the functioning of the healthcare system, particularly in rural areas, where access to medical services is most restricted. The problems identified indicate the need to implement measures aimed at improving the healthcare system, both at the level of local government and at the micro-social level, encompassing support for older adults and for those involved in their care. Design/Methodology/Approach: The study covered 185 older adults aged 65–88 residing in rural municipalities of Eastern Poland. Women predominated in the sample (N = 100), constituting 54.1% of all respondents. A quantitative strategy was applied, using the diagnostic survey method and an original questionnaire. The survey was administered in person by the authors of the article, which allowed for the efficient organisation of the research process, direct contact with respondents, and a high return rate of correctly completed questionnaires. The study was conducted between 5 March and 30 June 2026, in accordance with the principles of research ethics, in particular voluntary participation, respondent anonymity, and confidentiality of the data obtained. Findings: The study demonstrated the existence of a problem of exclusion of older adults from access to certain medical services. Significant difficulties were identified in accessing the care of medical specialists, physiotherapists, and psychologists. These limitations also stem from insufficient availability of public transport (bus and rail), a low level of digital competence, and a lack of intrinsic motivation to use the health services needed. The factors listed contribute to a deterioration in the health status of older adults. This problem is of particular importance in the context of the ongoing ageing process, which is often accompanied by chronic and coexisting diseases as well as a gradual decline in physical functioning, thereby increasing the demand for medical services. Practical implications: The findings of the study conducted among Polish older adults demonstrate the need for systemic action within the healthcare sector to improve their access to medical services, particularly in rural areas, both at the level of local government and at the micro-social level. It appears advisable to develop and finance support programmes for older adults, including improving access to health services, developing transport to medical facilities, health-promotion initiatives, and support in the use of e-health services. The importance of psychological services and the organisation of support groups, which may foster increased motivation among older adults to engage in health-promoting behaviours, should also be recognised. Originality/Value: The authors present the results of original and up-to-date research demonstrating the scale of the risk of exclusion of older adults from access to medical services in rural areas of Eastern Poland. The study identified the factors that, in the opinion of the older adults surveyed, most severely limit their ability to use selected health services. The issue addressed is of particular relevance in the context of the ongoing ageing of societies, observed both in Poland and worldwide, and the consequent increase in demand for medical services. The results obtained constitute a valuable empirical resource that may be used to design organisational and social interventions aimed at reducing the phenomenon of health-related exclusion among older adults, thereby improving their quality of life.