Living with a partner and health care use - results from the MONICA survey Augsburg in Southern Germany.

Psycho-social medicine Pub Date : 2007-12-07
Carola A Huber, Sebastian E Baumeister, Karl-Heinz Ladwig, Andreas Mielck
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Abstract

Objective: Several studies have shown that social relationships are associated with health care use. This study aims to test if and to which extent a proximal element of social relationships, particularly living together with a partner, influences the health care utilisation in the same way as a distal element such as group membership.

Methods: On the basis of a representative random sample of a southern German population (4856 participants), the associations were assessed between the following groups of variables: number of consultations with the general practitioner or internists, type of social relationships (living with a partner, friends, relatives, group memberships), need (evaluated and perceived health status), socio-demographic variables.

Results: All analyses showed associations between living with a partner and health care utilisation. Individuals living with a partner had lower levels of utilisation than individuals not living with a partner (mean: 4.3 vs. 5.2). These associations persisted after controlling for socio-demographic and need variables. For the other indicators of social relationships, though, there were no significant associations with outpatient visits.

Conclusions: Distinguishing between different types of social relationships is important for disentangling the overall effects of social relationships on health care utilisation. Also, the empirical findings confirm that health care research should not be restricted to medical variables, but should also include psycho-social factors.

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与伴侣一起生活和医疗保健的使用——来自德国南部奥格斯堡莫妮卡调查的结果。
目的:几项研究表明,社会关系与卫生保健使用有关。本研究旨在测试社会关系的近端因素,特别是与伴侣一起生活,是否以及在多大程度上影响医疗保健的利用,其方式与远端因素(如群体成员)相同。方法:在德国南部人口的代表性随机样本(4856名参与者)的基础上,评估了以下变量组之间的关联:与全科医生或内科医生的咨询次数、社会关系类型(与伴侣、朋友、亲戚、团体成员住在一起)、需求(评估和感知的健康状况)、社会人口变量。结果:所有的分析都显示了与伴侣生活和医疗保健利用之间的联系。与伴侣同居的个体比没有伴侣同居的个体的使用率更低(平均值:4.3 vs 5.2)。在控制了社会人口统计学和需求变量后,这些关联仍然存在。然而,对于社会关系的其他指标,与门诊就诊没有显著关联。结论:区分不同类型的社会关系对于理清社会关系对医疗保健利用的总体影响是重要的。同时,实证结果也证实了卫生保健研究不应局限于医学变量,而应包括心理社会因素。
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