Abstract
BackgroundIt 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.MethodsData 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.ResultsRegressions 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.ConclusionsOur 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.
Highlights
It remains an open question how changes in predisposing, enabling, and need factors affect health care use
Sample characteristics The pooled median for General Practitioners (GP) visits was 2.5 and the median for specialist visits was 2. 90% of participants had at least one visit to a GP during the 12 months preceding the interview and about 65% used services provided by a specialist
Since we were interested in the intra-individual changes, individuals were only included in the sample if they had changes in the outcome variable between wave 3 and wave 4
Summary
It remains an open question how changes in predisposing, enabling, and need factors affect health care use. Andersen and Newman [1] developed a theoretical framework for analyzing determinants of health care use in 1973. Over the years, this behavioral model has been further developed to a version published in 1995 [2], which distinguishes three categories of determinants of health care use: predisposing, enabling, and need factors. The Andersen model is a widely used framework to examine determinants of health care use [3]. This conceptual framework was used to select independent variables such as age or employment status
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