Levkoff S E, Cleary P D, Wetle T
Department of Social Medicine and Health Policy, Harvard Medical School, Boston, MA 02115.
Med Care. 1987 Dec;25(12):1148-60. doi: 10.1097/00005650-198712000-00004.
The authors examined whether there are differences in the determinants of physician use between aged and middle-aged individuals. Data were obtained through interviews and medical records from a probability sample of 460 individuals aged 45-89 years old. Physical health measures were important predictors for both age groups, but there were differences in the relative importance of specific variables. The number of diagnoses was more important in predicting physician use for the middle-aged and bed days was more significant for the aged. Psychologic factors played a slightly greater role in predicting physician use for the aged, and enabling and predisposing variables were somewhat more important for the middle-aged. Utilization during the year before the interview was associated with subsequent physician use for both age groups, but the correlation was weaker among the aged. Age differences in the predictors of physician use are believed to result from the unique illness response elicited by chronic, as opposed to acute, illness.
作者研究了老年人和中年人在就医决定因素上是否存在差异。数据通过对460名年龄在45 - 89岁的个体的概率样本进行访谈和查阅病历获得。身体健康指标对两个年龄组都是重要的预测因素，但特定变量的相对重要性存在差异。诊断数量在预测中年人的就医情况时更为重要，而卧床天数对老年人更为显著。心理因素在预测老年人的就医情况时作用稍大，促成因素和 predisposing 变量对中年人更为重要。访谈前一年的就医情况与两个年龄组随后的就医情况都相关，但老年人中的相关性较弱。就医预测因素的年龄差异被认为是由慢性疾病（而非急性疾病）引发的独特疾病反应导致的。
