Patterns of older Americans' health care utilization over time

Am J Public Health. 2013 Jul;103(7):1314-24. doi: 10.2105/AJPH.2012.301124. Epub 2013 May 16.

Abstract

Objectives: We analyzed correlates of older Americans' continuous and transitional health care utilization over 4 years.

Methods: We analyzed data for civilian, noninstitutionalized US individuals older than 50 years from the 2006 and 2008 waves of the Health and Retirement Study. We estimated multinomial logistic models of persistent and intermittent use of physician, inpatient hospital, home health, and outpatient surgery over the 2004-2008 survey periods.

Results: Individuals with worse or worsening health were more likely to persistently use medical care and transition into care and not transition out of care over time. Financial variables were less often significant and, when significant, were often in an unexpected direction.

Conclusions: Older individuals' health and changes in health are more strongly correlated with persistence of and changes in care-seeking behavior over time than are financial status and changes in financial status. The more pronounced sensitivity to health status and changes in health are important considerations in insurance and retirement policy reforms.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ambulatory Surgical Procedures / statistics & numerical data
  • Delivery of Health Care / economics
  • Delivery of Health Care / statistics & numerical data*
  • Delivery of Health Care / trends*
  • Female
  • Health Services / statistics & numerical data*
  • Health Status
  • Health Surveys
  • Home Care Services / statistics & numerical data
  • Hospitalization / statistics & numerical data
  • Humans
  • Income
  • Insurance Coverage
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Office Visits / statistics & numerical data
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Time Factors
  • United States