Which factors affect health care use among older Germans? Results of the German ageing survey, 2017, Hajek et al

[Midnattsol]

Abstract
Background

It remains an open question how changes in predisposing, enabling, and need factors affect health care use. Consequently, we aimed to investigate how changes in these variables affect health care use in community-dwelling older persons longitudinally.

Methods
Data from two waves of the German Ageing Survey (DEAS), a representative sample of the community-dwelling German population aged ≥40 years, was used. Predictors of visits to general practitioners and specialists as well as hospital stays during a 12-month period were analyzed by fixed effects regressions.

Results
Regressions revealed that the need factors ‘self-rated health’ and the number of chronic diseases affected all measures of health care use (except for the number of chronic diseases on hospital care). An increased duration of physical activities increased GP visits. A decrease of excess weight decreased the number of specialist visits.

Conclusions
Our findings underline the importance of need factors for health care use. Virtually none of the predisposing factors nor enabling resources affected health care use. These findings might indicate that individuals in the second half of life use health care services adequately, i.e. when medically indicated.

LINK (Open access)

 

[Utsikt]

Just linking your other recent post about self-rated health and cancer.

Seems like humans might be decent at judging their own health and medical needs.

 

[Midnattsol]

With all the talk of predisposing and maintaining factors, this study has some interesting findings, such as:

Furthermore, there was no robust effect of predisposing factors and enabling resources on any measure health care use.

In sum, our results indicate that there might be causal relationship between health-related need factors, both perceived and objectively measured, and health care use.

"Perceived" here refers to self-reported health, objective the self-reported number of chronic illnesses.

It appears highly plausible that changes in these need factors [self-reported health] are strongly associated with health care use.

This one really gets me

Apart from health-related need factors, we considered lifestyle factors as need factors and found physical activities to increase GP visits. Apparently, this finding appears to be counterintuitive, as one could assume that, in general, physical activities are associated with a healthier lifestyle, which should be associated with fewer visit to physicians. ... Yet in our longitudinal study, changes towards more physical activities entailed more GP visits. It might be that more physical activities lead to more GP visits due to injuries resulting from sports.

This was interesting. The population studied are germans >=40 years old (a new definition of old for me, it's usually >=65), and I wonder if sport injuries requiring a healthcare visit are common or not. They are looking at change in activity levels, and people who increase their activity may do so due to bad health, but then there are people like us, maybe exercise is not just beneficial.

 

[Utsikt]

This was interesting. The population studied are germans >=40 years old (a new definition of old for me, it's usually >=65), and I wonder if sport injuries requiring a healthcare visit are common or not. They are looking at change in activity levels, and people who increase their activity may do so due to bad health, but then there are people like us, maybe exercise is not just beneficial.

I can see how newly started physical activity might make you more aware of natural issued caused by age.

While 40 isn’t old in my books, age related issues probably starts even sooner.

Maybe the people that are more active also are more health-focused and therefore willing to address any issues? Pure speculation.