Factors related to frequent usage of the primary healthcare services in old age: findings from The Swedish National Study on Aging and Care

Abstract

People aged 60 or more are the most frequent users of healthcare services. In this age range, however, both frequent and infrequent users can be found. Frequent users have high rates of illnesses. Previous research has found that the frequency may be influenced also by psychological and social factors. The aim of this study was to investigate to what degree such factors add to the explanation of differences in number of visits to a physician. A cross-sectional study was conducted with a random sample consisting of 1017 individuals, aged 60 to 78 years, from the Blekinge part of the Swedish National Study on Aging and Care database. The data were collected during 2001 to 2003. Hierarchical logistic regression analyses were used with frequent (three visits or more during a year) and infrequent use as a dichotomous dependent variable. The final statistical analyses included 643 individuals (63% of the sample). Independent variables were sense of coherence (SOC), internal locus of control, education level and social anchorage. Control variables were age, gender, functional ability and comorbidity. The results showed that comorbidity was most strongly related to frequent use [adjusted odds ratio (OR) = 8.17, 95% confidence interval (CI) 5.54–12.04]. In addition, SOC and internal locus of control had small, but significant effects on the odds of being a frequent user (adjusted OR = 1.03, 95% CI 1.00–1.06 and adjusted OR = 1.14, 95% CI 1.02–1.27, respectively). The lower the SOC and the internal locus of control were, the higher were the odds of frequent use. Education level and social anchorage were unrelated to frequency of use. The results indicate that frequent healthcare services users are more ill than infrequent users. Psychological factors influence the use only marginally, and social factors as well as age and gender are not by themselves reason for frequent healthcare services use.

Prevalence and predictors of healthcare utilization among older people (60+): Focusing on ADL dependency and risk of depression

“…The participants received an invitation by mail to come twice to a primary health centre to participate in the study (Rennemark, Holst, et al, 2009). Those who did not respond were contacted again, this time by telephone.…”

“…Informed written consent was obtained from all participants at the first session (Rennemark, Holst, et al, 2009 …”

“…A literature review by Vogeli et al (2007) showed that people with one chronic disease visited physicians four times a year while those with five or more such diseases had fourteen visits. In Sweden hospital admissions and visits to outpatient physicians have also been showed to be mainly associated with medical diagnoses (Kristensson, et al, 2007) and co-morbidity (Rennemark, Holst, et al, 2009). This means that not only physical health symptoms, but also mental health symptoms, medical diagnosis and demographic data should be considered when studying healthcare utilization.…”

Purpose in life predicts allostatic load ten years later

“…These dimensions are not necessarily orthogonal as multi-causation often characterizes individuals’ convictions about their health outcomes [18]. Generally, high SHLC has been found to predict healthy lifestyle practices ([19], including use of health care services [20], while high OHLC has been associated with less healthy behaviors [19], which probably explains its link with poor physical [21] and mental health [22]. The hypothesis that purpose in life might be, at least partially, associated with health via modulation of health-control beliefs awaits empirical testing.…”

The effects of intervention on frequent attenders' adherence to health regimens, depression, somatization and hypochondriasis

“…[1,7,10] The main reason for health care use is illness, and therefore the roles of psychological, social, and demographical factors are secondary. FAs is the group that might be expected to benefit from community matrons, [11] who are experienced nurses with advanced practice skills using case management techniques with patients who have chronic diseases and who use of health care services intensively. Case management ensures a continuity of care for patients with complex care needs.…”