Hospitalizations and doctor visits among older adults in Europe: cross-country differences using a multilevel approach
Objective: To analyse the individual and country-level determinants of the use of healthcare systems by populations over 50 years of age in Europe. Method: We conducted a cross-sectional study using data from Wave 7 (2017) of the Survey of Health, Ageing, and Retirement in Europe. The analysis inclu...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | Gaceta Sanitaria |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0213911125000196 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Objective: To analyse the individual and country-level determinants of the use of healthcare systems by populations over 50 years of age in Europe. Method: We conducted a cross-sectional study using data from Wave 7 (2017) of the Survey of Health, Ageing, and Retirement in Europe. The analysis included 27 countries. We fitted multilevel mixed-effects logistic regression models with hospitalization and doctor visits per person per year as dependent variables. Results: The findings suggest that country-level variables explain between 3.3% and 4.9% of the differences in the likelihood of hospitalizations and approximately 10% of the likelihood of visiting a doctor at least once a year. Life expectancy and number of beds were the country-level variables most strongly associated with a reduced probability of hospitalization and doctor visits, respectively. The study also found that comorbidity and employment status were risk factors associated with hospitalization and doctor visits, while physical activity was a protective factor. Conclusions: Country-level factors positively associated with higher health service use are the number of beds, health expenditure per capita and preventable mortality. Life expectancy and treatable mortality are negatively associated with the use of these services. Greater comorbidity increase the likelihood of hospitalization and medical visits, while higher muscular strength or regular physical activity reduce them. Resumen: Objetivo: Analizar los determinantes individuales y de cada país asociados al uso de los sistemas sanitarios por parte de la población mayor de 50 años en Europa. Método: Estudio transversal utilizando datos de la ola 7 (2017) de la Survey of Health, Aging, and Retirement in Europe. Se incluyeron 27 países y se realizaron modelos de regresión logística multinivel con efectos mixtos. Las variables dependientes fueron la hospitalización y las visitas médicas por persona y por año. Resultados: Los hallazgos sugieren que las variables de país explican entre el 3,3% y el 4,9% de las diferencias en la probabilidad de hospitalizaciones, y aproximadamente el 10% de la probabilidad de visitar a un médico al menos una vez al año. La esperanza de vida y el número de camas fueron las variables que más se asociaron con una menor probabilidad de hospitalización y visitas al médico. La comorbilidad y la situación laboral fueron factores de riesgo de la hospitalización, y las visitas al médico y la actividad física fueron un factor protector. Conclusiones: Los factores de país asociados positivamente a un mayor uso de servicios sanitarios son el número de camas, el gasto en salud per cápita y la mortalidad prevenible. La esperanza de vida y la mortalidad tratable están negativamente asociadas al uso de estos servicios. Una mayor comorbilidad aumenta la probabilidad de hospitalización y consultas médicas, mientras que una mayor fuerza muscular y la práctica de actividad física la reducen. |
|---|---|
| ISSN: | 0213-9111 |