Body awareness and medical care utilization among older adults in an HMO
Article Abstract:
The elderly use more health care services than any other group, and therefore their contribution to medical care expenses is disproportionately large. Much of the relevant research suggests that poor health status largely determines this utilization pattern. Other influential factors include availability of social supports, marital status, occurrence of stressful life events, unemployment, increasing age, availability of insurance, and transportation. Lacking from the research literature, however, are the psychological components of the elderly population's utilization of health care services. The concept of body awareness incorporates attention paid to one's internal body sensations, and is hypothesized to play a role in medical care utilization. A random sample of 741 members of a health maintenance organization (HMO) was selected for study to test this hypothesis. Subjects were within three age groups: 62 to 64 years, 65 to 74 years, and 75 years and over. Medical record data were analyzed to determine utilization of the HMO's services, and self-reports provided data on body awareness. Over the long term, there were a greater number of HMO visits for subjects who had a greater body awareness, and these subjects were also the most likely to use emergency services (health status and other possible confounding factors were controlled for.) Interestingly, physician-initiated follow-up visits and referrals did not show a similar relationship to subjects' body awareness, although more physician-initiated contact was related to greater patient-initiated contact. The data suggest that there is a correlation between heightened body awareness and more frequent patient-initiated utilization of medical care. It is also suggested that increased patient-initiated contact may be related to an increased likelihood of physician-initiated contact in the future. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journals of Gerontology
Subject: Seniors
ISSN: 0022-1422
Year: 1991
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The use of health services by older adults
Article Abstract:
The elderly, who represent a growing proportion of the population, consume a disproportionate share of medical services. At present, the elderly represent one eighth of the population, but utilize one third of total health care services. Data from the Longitudinal Study on Aging (LSOA) were analyzed to assess older adults' use of health care services and to provide benchmark information for ongoing longitudinal study of the data. The LSOA contains information from interviews from 5,151 respondents. The analysis considers three conceptual components: predisposition to use health care; enablement, or the means to obtain health care; and need, the immediate reason, such as illness, for seeking health care. Need was the most important of the three, leading several earlier researchers have to conclude that the system is equitable. This conclusion may be inaccurate, first because much of the variation in usage is not accounted for, and second, because the needs themselves are different for minority and majority populations. Recent research suggests that the use of health care services by older minority group members is much more constrained by need. Research indicates that having a sense of control over one's health not only reduces health services utilization, but reduces the risk of dying, perhaps because these patients are less likely to give up. Social support was very important, whether from relatives or friends. Friends and relatives were equally important in terms of physician contact. However, friends were more important in reducing the number of bed-disability days, length of hospital stay, nursing home placement, and the risk of dying. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journals of Gerontology
Subject: Seniors
ISSN: 0022-1422
Year: 1991
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Use of health services in later life: the influence of health beliefs
Article Abstract:
The elderly constitute the largest group of adult health care users, but surveys have determined that only a small segment of this population accounts for most of their usage of resources. Whether this is due to need or to other factors is unknown, and the issue has been studied within a framework that encompasses three determinants of utilization: predisposing factors, enabling factors, and need factors. Often lacking in these analyses, however, are the predisposing factors of health beliefs, attitudes, and knowledge. To better understand the influence of health beliefs on utilization of medical services, a random sample of individuals aged 60 years and older was studied. The final study sample consisted of 743 people; data were collected by interview on sociodemographics and utilization of services within the past year. Measures included number of physician visits, hospital utilization, and overall health service use, as well as predisposing factors such as health beliefs, enabling factors (e.g., adequate income), and need. Need factors, specifically perceived poor health, chronic conditions, pain, worry, and need for assistance with activities of daily living, emerged as the most significant influences in determining utilization of services. Medical skepticism played a role as well, particularly in the number of physician visits. A belief in preventive medicine correlated with a greater overall use of services. It is suggested that specific illness episodes be examined so that decisions regarding health care utilization can be tracked. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journals of Gerontology
Subject: Seniors
ISSN: 0022-1422
Year: 1991
User Contributions:
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