Multidimensional social support is associated with healthcare utilization among older Mexican adults

Abstract

In this study, we aimed to estimate the association between social support and healthcare utilization among older Mexican adults. We conducted a prospective study with 4027 older adults aged 65-74 in rural areas in seven Mexican states. Data were collected at baseline (2007) and 14 months later (2009). Healthcare utilization was defined as number of visits to a physician for preventive or curative purposes in the last 6 months. Multidimensional social support was operationalized into two components: structural (living arrangements, marital status and network size) and functional (perceived availability of support; and perceived support across emotional, instrumental, economic and information domains). Mixed-effects regression models were used to estimate the probability of healthcare use and to examine the association between social support and the number of visits to a physician. Results showed that perceived availability of social support was associated with the probability of visits to a physician (OR 1.44; < .01). Meanwhile, the following domains of functional component of social support were associated with the probability of visits to a physician: instrumental (OR 1.55; < .01), economic (OR 1.19; = .03) and informational (OR 1.39; < .01); and also with the number of visits to a physician: instrumental (e = 1.27; < .01), economic (e = 1.14; = .01) and informational (e = 1.12; < .10). Our findings suggest that a significant association exists between social support, measured from a multidimensional viewpoint, and healthcare utilization, in which greater social support was related to a greater extent of use of health services.

Multidimensional Social Support and Health Services Utilization Among Noninstitutionalized Older Persons in Ghana

“…Participants reporting more access to informal social support had higher health care utilization rates. Previous studies have proposed social support as an enabling factor providing a strong linkage between the need for health care and the actual utilization of the available health services (Litwin, 1997; Salinas-Rodriguez et al, 2018), particularly among older adults who may present with comorbidities and other physical disabilities, and with limited socioeconomic resources. The findings of this study provide some evidence to support these findings.…”

“…Maulik, Eaton, and Bradshaw (2010) further reported that increased social support decreased the odds of using mental health services and speciality care by 60% and 40% to 50%, respectively. Other studies found that greater social support significantly relates to health care use among older persons (e.g., Melchiorre et al, 2013; Salinas-Rodriguez et al, 2018). However, these diverse observations may not reflect the situation in Ghana due to sociocultural and demographic peculiarities (Gyasi, Buor, et al, 2018).…”

“…Indeed, relatively little is understood about which specific aspects of social support network most significantly relate to older adults’ health care use or nonuse in countries such as Ghana. Moreover, observations from more developed countries and some LMICs have presented mixed evidence (Pilisuk, Boylan, & Acredolo, 1987; Salinas-Rodriguez, Moreno-Tamayo, Hernández-Serrato, Enríquez-Rosas, & Manrique-Espinoza, 2018). For instance, historically, social support has been found to have a buffering effect on medical service use in stressful situations (Pilisuk et al, 1987) but other studies did not find evidence to support the stress-buffering effect of social support on service use but rather found that the number of close friends or relatives reduced service use.…”

Outpatient primary and tertiary healthcare utilisation among public rental housing residents in Singapore

“…In contrast to primary care where services are typically provided within fixed-length appointment slots, specialists’ appointment lengths are highly variable and diagnosis-dependent, which may result in variable waiting times and inconvenience to patients [38]. Strong social support has also been shown to increase the probability of physician visits [39]. Although the level of social support among public rental housing residents was not assessed in this study, the lack of social support among public rental housing residents may potentially reduce their adherence to specialist outpatient clinic visits, especially among patients with ambulatory problems and should be explored in future studies.…”

Out-of-Pocket Healthcare Expenditures in Dependent Older Adults: Results From an Economic Evaluation Study in Mexico

“…However, since 2009 Mexico has a non-contributory pension program (formerly known as 70 y más−70 and over, and now as the Programa para el Bienestar de los Adultos Mayores -Program for the Welfare of Older Adults) which consists of the bimonthly payment of 2,750 Mexican pesos (115 US dollars approx. ), and is intended to be universal to all individuals 68 years of age or older (11,12).…”