Salinas-Rodríguez Aarón, Moreno-Tamayo Karla, Hernández-Serrato María, Enríquez-Rosas María Del Rocío, Manrique-Espinoza Betty Soledad
1Center for Evaluation Research and Surveys, National Institute of Public Health, Av. Universidad #655, Col. Santa María Ahuacatitlán, 62100 Cuernavaca, MOR Mexico.
2Epidemiological Research Unit and Health Services, National Medical Center XXI Century, Mexican Social Security Institute, Av. Cuauhtémoc #330, Col. Doctores, 06720 Mexico City, Mexico.
Eur J Ageing. 2017 Apr 28;15(1):77-85. doi: 10.1007/s10433-017-0428-1. eCollection 2018 Mar.
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.
在本研究中,我们旨在评估墨西哥老年成年人的社会支持与医疗保健利用之间的关联。我们对墨西哥七个州农村地区的4027名65 - 74岁老年人进行了一项前瞻性研究。数据在基线时(2007年)和14个月后(2009年)收集。医疗保健利用被定义为过去6个月内因预防或治疗目的就诊的次数。多维社会支持被操作化为两个组成部分:结构方面(生活安排、婚姻状况和社交网络规模)和功能方面(感知到的支持可用性;以及在情感、工具、经济和信息领域感知到的支持)。使用混合效应回归模型来估计医疗保健使用的概率,并检验社会支持与就诊次数之间的关联。结果显示,感知到的社会支持可用性与就诊概率相关(比值比1.44;P <.01)。同时,社会支持功能组成部分的以下领域与就诊概率相关:工具性支持(比值比1.55;P <.01)、经济支持(比值比1.19;P =.03)和信息支持(比值比1.39;P <.01);并且也与就诊次数相关:工具性支持(指数系数 = 1.27;P <.01)、经济支持(指数系数 = 1.14;P =.01)和信息支持(指数系数 = 1.12;P <.10)。我们的研究结果表明,从多维角度衡量的社会支持与医疗保健利用之间存在显著关联,其中更大的社会支持与更高程度的医疗服务使用相关。