Tufts University, USA.
J Health Econ. 2013 Jan;32(1):33-50. doi: 10.1016/j.jhealeco.2012.10.010. Epub 2012 Nov 2.
There is ample evidence that bereavement is associated with heightened mortality. Regardless of whether this strong association is truly causal, little is known about the factors contributing to it. This study begins to unpack the black box of the bereavement-mortality puzzle by investigating the extent to which heath behaviors and health care utilization patterns vary among chronically ill elderly males living with a spouse and those who are widowed, and by asking whether these differences contribute to the well-documented correlation between widowhood and health deterioration. In order to separate the effect of health care utilization from other potential channels it uses a unique dataset of doctor-patient encounters that allows in-depth analysis of the organization and effectiveness of medical care. Changes in health care utilization attributable to bereavement have a negative effect on survival but account for a small part of the overall negative effect of widowhood on longevity.
有充分的证据表明,丧偶与死亡率升高有关。无论这种强烈的关联是否真正具有因果关系,人们对导致这种关联的因素知之甚少。本研究通过调查患有慢性疾病的老年男性在与配偶生活和丧偶时的健康行为和医疗保健利用模式的差异程度,并询问这些差异是否有助于解释丧偶与健康恶化之间的明确关联,开始揭开丧偶与死亡率之谜的黑箱。为了将医疗保健利用的影响与其他潜在渠道分开,它使用了一组独特的医患就诊数据集,允许对医疗保健的组织和效果进行深入分析。由于丧偶而导致的医疗保健利用的变化对生存有负面影响,但仅占丧偶对长寿的整体负面影响的一小部分。