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医疗保健利用与主观幸福感之间存在联系吗?一项针对丹麦老年人的探索性研究。

Is there a link between health care utilisation and subjective well-being? An exploratory study among older Danes.

作者信息

Aaskoven Maiken Skovrider, Kjær Trine, Gyrd-Hansen Dorte

机构信息

DaCHE - Danish Centre for Health Economics, Department of Public Health, University of Southern Denmark, Campusvej 55, Odense M, 5230, Denmark.

出版信息

Eur J Health Econ. 2025 Feb;26(1):87-93. doi: 10.1007/s10198-024-01691-1. Epub 2024 May 8.

Abstract

While extensive research has explored the influence of traditional factors such as socioeconomic position on health care utilisation, the independent role of an individual's well-being in their health care seeking behaviour remains largely uncharted territory. In this study, we delve into the role of subjective well-being (SWB) in health care utilisation. We use a unique link between survey data from a representative group of Danish citizens aged 50-80 and administrative register data containing information on health care utilisation and sociodemographics. We explore whether SWB is a predictor of health care utilisation (general practice services) over and above health (as measured by health-related quality of life (HRQoL)). We find that the association between SWB and number of services provided in general practice differs across levels of HRQoL. Among those with lower HRQoL, we find a positive association between health care utilisation and SWB. Results hold true even when controlling for previous health care utilisation, suggesting that the mechanism is not driven by reverse causality. Our findings suggest that, in particular for vulnerable individuals in poor health and with poor SWB, the propensity to seek care is inappropriately low, and there is a need for more proactive supply-driven health care.

摘要

虽然广泛的研究探讨了社会经济地位等传统因素对医疗保健利用的影响,但个人幸福感在其就医行为中的独立作用在很大程度上仍是未知领域。在本研究中,我们深入探讨主观幸福感(SWB)在医疗保健利用中的作用。我们利用了一组年龄在50 - 80岁的丹麦代表性公民的调查数据与包含医疗保健利用和社会人口统计学信息的行政登记数据之间的独特联系。我们探究了主观幸福感是否是除健康(以健康相关生活质量(HRQoL)衡量)之外医疗保健利用(全科医疗服务)的一个预测因素。我们发现,主观幸福感与全科医疗服务提供数量之间的关联在不同健康相关生活质量水平上存在差异。在健康相关生活质量较低的人群中,我们发现医疗保健利用与主观幸福感之间存在正相关。即使在控制了先前的医疗保健利用情况后,结果仍然成立,这表明该机制并非由反向因果关系驱动。我们的研究结果表明,特别是对于健康状况不佳且主观幸福感较低的弱势群体而言,寻求医疗服务的倾向低得不合理,因此需要更积极的供应驱动型医疗保健。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ed5/11743418/5c64ddf97690/10198_2024_1691_Fig1_HTML.jpg

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