Dental Public Health, University of Maryland School of Dentistry, Baltimore, MD 21201, USA.
Am J Public Health. 2013 Jul;103(7):1314-24. doi: 10.2105/AJPH.2012.301124. Epub 2013 May 16.
We analyzed correlates of older Americans' continuous and transitional health care utilization over 4 years.
We analyzed data for civilian, noninstitutionalized US individuals older than 50 years from the 2006 and 2008 waves of the Health and Retirement Study. We estimated multinomial logistic models of persistent and intermittent use of physician, inpatient hospital, home health, and outpatient surgery over the 2004-2008 survey periods.
Individuals with worse or worsening health were more likely to persistently use medical care and transition into care and not transition out of care over time. Financial variables were less often significant and, when significant, were often in an unexpected direction.
Older individuals' health and changes in health are more strongly correlated with persistence of and changes in care-seeking behavior over time than are financial status and changes in financial status. The more pronounced sensitivity to health status and changes in health are important considerations in insurance and retirement policy reforms.
我们分析了 4 年来美国老年人连续和过渡性医疗保健利用的相关因素。
我们分析了来自健康与退休研究 2006 年和 2008 年两个波次的 50 岁以上的美国平民和非住院个体的数据。我们使用多项逻辑回归模型估计了在 2004-2008 年调查期间，医生、住院病人、家庭保健和门诊手术的持续和间歇性使用情况。
健康状况较差或恶化的个体更有可能持续使用医疗保健，并随着时间的推移过渡到医疗保健，而不是退出医疗保健。财务变量通常不太显著，而且当显著时，往往方向出乎意料。
与财务状况和财务状况的变化相比，老年人的健康状况和健康状况的变化与随时间推移的寻求医疗保健行为的持续和变化更密切相关。对健康状况和健康状况变化的敏感性更强，这是保险和退休政策改革的重要考虑因素。
