Reber Katrin Christiane, König Hans-Helmut, Hajek André
Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.
J Occup Med Toxicol. 2018 Oct 25;13:33. doi: 10.1186/s12995-018-0216-7. eCollection 2018.
So far, studies within the occupational field have largely concentrated on working conditions and job stressors and staff members' or subordinate health. Only a few have focused on managers in this context, but studies are missing that explicitly look at the relation between leadership position and health care use (HCU). Thus, the purpose of this study was to examine the potential effects of a change in leadership position on HCU in women and men longitudinally.
Data were drawn from a nationally representative longitudinal study in Germany (German Socio-Economic Panel, GSOEP). Data from 2009 and 2013 were used. Leadership position was divided into (i) top management, (ii) middle management, (iii) lower management, and (iv) a highly qualified specialist position. The number of physician visits in the preceding 3 months were used to quantify HCU ( = 2140 observations in regression analysis; 69% male).
Adjusting for various potential confounders (e.g., age, self-rated health, chronic conditions, and personality factors), Poisson FE regression analysis revealed that changes from a highly qualified specialist position to the top management were associated with a in the number of physician visits in men (β = .47, < .05), but not in women. Gender differences (gender x leadership position) were significant.
Findings of this study emphasize the impact of leadership positions on the number of physician visits in men. Further study is required to elucidate the underlying mechanisms.
到目前为止，职业领域的研究主要集中在工作条件、工作压力源以及员工或下属的健康状况上。在此背景下，仅有少数研究关注管理者，但缺乏明确考察领导职位与医疗保健利用（HCU）之间关系的研究。因此，本研究的目的是纵向考察领导职位变化对男性和女性医疗保健利用的潜在影响。
数据来自德国一项具有全国代表性的纵向研究（德国社会经济面板研究，GSOEP）。使用了2009年和2013年的数据。领导职位分为：（i）高层管理，（ii）中层管理，（iii）基层管理，以及（iv）高素质专业职位。用前3个月内看医生的次数来量化医疗保健利用情况（回归分析中有2140个观察值；69%为男性）。
在对各种潜在混杂因素（如年龄、自评健康状况、慢性病和人格因素）进行调整后，泊松固定效应回归分析显示，从高素质专业职位转变为高层管理职位与男性看医生次数的[此处缺失内容]有关（β = 0.47，P < 0.05），但在女性中并非如此。性别差异（性别×领导职位）显著。
本研究结果强调了领导职位对男性看医生次数的影响。需要进一步研究以阐明其潜在机制。
