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自我衰老感知、全科医生就诊和频繁就诊。德国老龄化调查的纵向研究结果。

Self-perceptions of ageing, GP visits and frequent attendance. Longitudinal findings from the German Ageing Survey.

机构信息

Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

出版信息

Aging Ment Health. 2021 Aug;25(8):1493-1498. doi: 10.1080/13607863.2020.1742659. Epub 2020 Mar 19.

Abstract

OBJECTIVES

The aim of this study was to clarify the link between self-perceptions of ageing and the number of general practitioner (GP) visits, as well as frequent GP visits, longitudinally.

METHODS

In this study, longitudinal data with  = 7,062 observations from 2014 (wave 5) to 2017 (wave 6) were taken from the German Ageing Survey (representative sample of middle aged and older individuals residing in private households). The five-item Attitudes Toward Own Ageing subscale of the Philadelphia Geriatric Center Morale Scale (PGCMS) was used to quantify self-perceptions of ageing. The frequency of GP visits in the past 12 months served as outcome measure (first model: measured continuously; second model: top 10% were defined as frequent attenders). To exploit the features of panel data, and to mitigate the problem of unobserved heterogeneity, fixed effects regressions were used.

RESULTS

Adjusting for predisposing characteristics, enabling resources and need-factors, regressions showed that an increase in self-perceptions of ageing was associated with decreases in the number of GP visits (IRR= .83 (95% CI: .77-.91)), and a decreased likelihood of becoming a frequent attender (OR= .44 (95% CI: .29-.66)).

CONCLUSIONS

Using data from a longitudinal study and exploiting the longitudinal data structure, the current study adds to our current knowledge by demonstrating that self-perceptions of ageing contribute to the frequency of GP visits as well as frequent attendance. Since self-perceptions of ageing are modifiable, this may help to manage health care use.

摘要

目的

本研究旨在阐明自我衰老认知与全科医生(GP)就诊次数以及频繁就诊之间的纵向联系。

方法

本研究采用来自德国老龄化调查(居住在私人家庭中的中年和老年人的代表性样本)的 2014 年(第 5 波)至 2017 年(第 6 波)的纵向数据(共 7062 个观测值)。使用费城老年中心士气量表(PGCMS)的 5 项对自身衰老态度分量表来量化自我衰老认知。过去 12 个月内 GP 就诊的频率作为结果测量指标(第一模型:连续测量;第二模型:将前 10%定义为频繁就诊者)。为了利用面板数据的特点,并减轻未观察到的异质性问题,使用固定效应回归。

结果

在调整了倾向特征、使能资源和需求因素后,回归显示自我衰老认知的增加与 GP 就诊次数的减少相关(IRR=0.83(95%CI:0.77-0.91)),且成为频繁就诊者的可能性降低(OR=0.44(95%CI:0.29-0.66))。

结论

本研究使用纵向研究的数据并利用纵向数据结构,通过证明自我衰老认知对 GP 就诊次数和频繁就诊的影响,增加了我们目前的知识。由于自我衰老认知是可改变的,这可能有助于管理医疗保健的使用。

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