Cafferata G L
National Center for Health Services Research and Health Care Technology Assessment, Rockville, MD 20857.
J Gerontol. 1987 Nov;42(6):613-8. doi: 10.1093/geronj/42.6.613.
Although marriage has been shown to have important health-protective consequences, it is not clear to what extent these effects are due to marriage per se or to the fact that married people are less likely to live alone. The social support literature suggests that living with others may reduce the need for use of formal and informal health care services independently of marital status because of (a) the substitution of home care, and/or (b) enhancement of physical and mental health. This study of elderly persons, based on data from the National Medical Care Expenditure Survey (NMCES), examined the substitution hypothesis. The impact of marital status and living arrangements on the use of formal health services among persons 65 years of age and older was examined using path analysis. These data confirm a substitution effect whereby persons living with others are more likely to stay in bed, but less likely to see a doctor, than are persons who live alone.
尽管婚姻已被证明具有重要的健康保护作用，但尚不清楚这些影响在多大程度上是由于婚姻本身，还是由于已婚者不太可能独自生活这一事实。社会支持文献表明，与他人生活在一起可能会减少独立使用正式和非正式医疗服务的需求，这是因为（a）家庭护理的替代，和/或（b）身心健康的改善，而与婚姻状况无关。这项基于国家医疗支出调查（NMCES）数据的老年人研究检验了替代假说。使用路径分析研究了婚姻状况和生活安排对65岁及以上人群使用正式医疗服务的影响。这些数据证实了一种替代效应，即与他人生活在一起的人比独自生活的人更有可能卧床，但看医生的可能性更小。
