Healthcare access and care experiences among adults aged 80 years and older: a qualitative study

Population aging is increasing worldwide, and adults aged 80 years and older represent a growing group with complex healthcare needs. Although healthcare access among older adults has been widely discussed, qualitative evidence focusing specifically on the experiences of adults aged 80 years and older remains relatively limited. This study aimed to explore healthcare access and care experiences among adults aged 80 years and older attending a Healthy Aging Center within a university-affiliated tertiary care hospital in Türkiye.

This qualitative study included adults aged 80 years and older. Participants were recruited using purposive sampling to seek variation in age, sex, educational background, and living arrangement. Data were collected through face-to-face, audio-recorded semi-structured interviews and analyzed using thematic analysis. Recruitment was discontinued when the dataset was considered sufficiently coherent and well supported to address the study aim and additional interviews were unlikely to materially alter the developing thematic structure.

Seven main themes were identified: access through appointment and digital systems, physical and transportation burden in reaching care, family support as an enabler of access, communication as a source of trust and feeling valued, hospital processes as a source of physical and organizational burden, expectations for priority, guidance, and age-sensitive care, and positive system appraisals alongside persistent barriers. Participants described healthcare access and care experiences as conditional and multidimensional. Difficulties in obtaining timely appointments, limited ability to use telephone-based or digital appointment systems, physical fatigue, transportation burden, and reliance on family or informal caregiver support shaped access to care. Doctor-patient communication, including being listened to, receiving clear explanations, and being examined, was central to trust and perceived quality of care. Crowding, waiting, and navigation difficulties made hospital use physically demanding, while participants also expressed expectations for priority access, guidance, and age-sensitive service arrangements. Positive evaluations of the healthcare system coexisted with reported barriers and were interpreted cautiously rather than as evidence that unmet needs were absent.

Healthcare access among adults aged 80 years and older is shaped by interacting digital, physical, relational, communicative, organizational, and age-related factors. Access was generally not perceived as completely impossible, but as dependent on timely appointments, digital or telephone support, physical capacity, family assistance, and the ability to navigate healthcare processes. These findings highlight the need for age-sensitive healthcare pathways, including simplified appointment systems, support for digital access, physically manageable hospital environments, clear guidance, and respectful communication.