Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-27T19:27:31.649Z Has data issue: false hasContentIssue false

A Prospective Analysis of the Relation Between Self-Rated Health and Health Care Use Among Elderly Canadians

Published online by Cambridge University Press:  29 November 2010

Verena H. Menec
Affiliation:
University of Manitoba
Judith G. Chipperfield
Affiliation:
University of Manitoba

Abstract

Research indicates that self-rated health is related to a variety of health-related outcomes, such as mortality and functional disability, even when controlling for more “objective” health measures. The present study extends previous research by prospectively examining the relation between self-rated health and health care use among a representative sample of elderly Canadians (N = 1,181) interviewed in 1991/92. Survey data were linked to administrative records of health care use. Self-rated health was positively related to the number of physician visits during the 12 months following the survey, as well as to the number of tests incurred (e.g., laboratory tests, X-rays), even when controlling for demographic variables, functional disability, morbidity, and prior health care use. Older adults who rated their health as “bad/poor” or “fair” were also more likely to be hospitalized than those who rated their health as “excellent”. These results highlight the importance of considering global measures of health when examining health care use.

Résumé

La recherche indique que l'auto-évaluation de la santé est associée sur une variété de séquelles sanitaires, notamment la mortalité et l'invalidité fonctionnelle, même dans les cas où Ton contrôle ces mesures de santé «objectives». L'étude poursuit la recherche déjà amorcée dans ce domaine et tente d'établir la relation éventuelle entre la santé auto-évaluée et l'utilisation des soins de santé dans un échantillonnage représentatif d'aîné(e)s canadien(ne)s (N= 1,181) interrogé(e)s en 1991/92. Les résultats du sondage ont été compares à des dossiers administratifs d'utilisation de soins de santé. La santé auto-évaluée était nettement reliée au nombre de visites chez le médecin durant les 12 mois qui ont suivi l'enquête ainsi qu'au nombre de tests subis (tests de laboratoire, rayons-X etc.), même en contrôlant les variables démographiques, l'invalidité fonctionnelle, la morbidité et l'utilisation antérieure des soins de santé. Les aîné(e)s qui avaient évalué leur santé comme «mauvaise» ou «acceptable» étaient également plus susceptibles d'être hospitalisés que ceux qui la jugeaient «excellente». Les résultats soulignent l'importance de la prise en compte de mesures globales de santé dans le cadre d'un examen de l'utilisation des soins de santé.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andersen, R.M. (1968). A behavioral model of families' use of health services. Chicago: Center for Health Administration Studies.Google Scholar
Andersen, R.M., & Newman, J. (1973). Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Quarterly, 51, 95124.CrossRefGoogle ScholarPubMed
Benyamini, Y., & Idler, E.L. (1999). Community studies reporting association between self-rated health and mortality. Research on Aging, 21, 392401.CrossRefGoogle Scholar
Branch, L.G., & Meyers, A.R. (1987). Assessing physical function in the elderly. Clinics in Geriatric Medicine, 3, 2951.CrossRefGoogle ScholarPubMed
Carsjö, K., Thorslund, M., & Wärneryd, B. (1994). The validity of survey data on utilization of health and social services among the very old. Journal of Gerontology: Social Sciences, 49, S156–S164.CrossRefGoogle ScholarPubMed
Chipperfield, J.G. (1993). Incongruence between health perceptions and health problems: Implications for survival among seniors. Journal of Aging and Health, 5, 475496.CrossRefGoogle Scholar
Chipperfield, J.G., & Segall, A. (1996). Seniors' attributions for problems with everyday tasks: Implications for well-being and coping strategies. Journal of Aging and Health, 8, 489511.CrossRefGoogle Scholar
Eve, S.B. (1988). A longitudinal study of use of health care services among older women. Journal of Gerontology: Medical Sciences, 43, M31–M39.CrossRefGoogle ScholarPubMed
Idler, E.L. (1999). Self-assessments of health: The next stage of studies. Research on Aging, 21, 387391.CrossRefGoogle Scholar
Idler, E.L., & Anger, R.J. (1990). Self-rated health and mortality in the NHANES-I epidemiologic follow-up study. American Journal of Public Health, 80, 446452.CrossRefGoogle ScholarPubMed
Idler, E.X., & Benyamini, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38, 2137.CrossRefGoogle ScholarPubMed
Idler, E.L., & Kasl, S.V. (1991). Health perceptions and survival: Do global evaluations of health status really predict mortality? Journal of Gerontology: Social Sciences, 46, S55–S65.CrossRefGoogle ScholarPubMed
Idler, E.L., & Kasl, S.V. (1995). Self-ratings of health: Do they also predict change in functional ability? Journal of Gerontology: Social Sciences, 50B, S344–S353.CrossRefGoogle Scholar
Jewett, J.J., Hibbard, J.H., & Weeks, E.C. (1991–1992). Predictors of health care use for the young-old and the old-old: A structural modeling approach. Behavior, Health and Aging, 2, 2941.Google Scholar
Kaplan, G.A., & Camacho, T. (1983). Perceived health and mortality: A nine-year follow-up of the Human Population Laboratory Cohort. American Journal of Epidemiology, 117, 292304.CrossRefGoogle ScholarPubMed
Katz, S., Ford, A.B., Moskowitz, R.W., Jackson, B.A., & Jaffee, M.W. (1963). Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. Journal of the American Medical Association, 185, 914919.CrossRefGoogle Scholar
Maddox, G.L. (1999). Commentary on the self-reported health symposium. Research on Aging, 21, 501506.CrossRefGoogle Scholar
Mechanic, D. (1979). Correlates of physician utilization: Why do major multivariate studies of physician utilization find trivial psychosocial and organizational effects? Journal of Health and Social Behavior, 20, 387396.CrossRefGoogle ScholarPubMed
Menec, V.H., Chipperfield, J.G., & Perry, R.P. (1999). Self-perceptions of health: A prospective analysis of mortality, control, and health. Journal of Gerontology: Psychological Science, 54B, P85–P93.CrossRefGoogle Scholar
Mossey, J.M., & Shapiro, E. (1982). Self-rated health: A predictor of mortality among the elderly. American Journal of Public Health, 72, 800808.CrossRefGoogle Scholar
Mutran, E., & Ferraro, K.F. (1988). Medical need and use of services among older men and women. Journal of Gerontology: Social Sciences, 43, S162–S171.CrossRefGoogle ScholarPubMed
Penning, M.J., & Strain, L.A. (1994). Gender differences in disability, assistance, and subjective well-being in later life. Journal of Gerontology: Social Sciences, 49, S202–S208.CrossRefGoogle ScholarPubMed
Pijls, L.T.J., Feskens, E.J.M., & Kromhout, D. (1993). Self-rated health, mortality, and chronic disease in elderly men: The Zutphen Study, 1985–1990. American Journal of Epidemiology, 138, 840848.CrossRefGoogle ScholarPubMed
Rodin, J., & MacAvay, G. (1992). Determinants of change in perceived health in longitudinal study of older adults. Journal of Gerontology: Psychological Sciences, 47, P373–P384.CrossRefGoogle ScholarPubMed
Roos, L.L., Roos, N.P., Gageorge, S.M., & Nicol, J.P. (1982). How good are the data? Reliability of one health care data bank. Medical Care, 20, 266276.CrossRefGoogle ScholarPubMed
Shadbolt, B. (1997). Some correlates of self-rated health for Australian women. American Journal of Public Health, 87, 951956.CrossRefGoogle ScholarPubMed
Strain, L. (1991). Use of health services in later life: The influence of health beliefs. Journal of Gerontology, 46, S143–S150.CrossRefGoogle ScholarPubMed
Wolinsky, F.D., & Coe, R.M. (1984). Physician and hospital utilization among noninstitutionalized elderly adults: An analysis of the Health Interview Survey. Journal of Gerontology, 39, 334341.CrossRefGoogle ScholarPubMed
Wolinsky, F.D., Culler, S.D., Callahan, C.M., & Johnson, R.J. (1994). Hospital resource consumption among older adults: A prospective analysis of episodes, length of stay, and charges over a seven-year period. Journal of Gerontology: Social Sciences, 49, S240–S252.CrossRefGoogle Scholar
Wolinsky, F.D., & Johnson, R.J. (1991). The use of health services by older adults. Journal of Gerontology: Social Sciences, 46, S345–S357.CrossRefGoogle ScholarPubMed
Wolinsky, F.D., & Johnson, R.J. (1992). Perceived health status and mortality among older men and women. Journal of Gerontology: Social Sciences, 47, S304–S312.CrossRefGoogle ScholarPubMed
Zimmer, Z., & Segall, A. (1992). Needs Assessment Survey methodology (Tech. Report No 1). Winnipeg: University of Manitoba, Centre on Aging, CARNET Research Group A.Google Scholar