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Differences in medical specialist utilization among older people in need of long-term care - results from German health claims data.

ABSTRACT: BACKGROUND:Elderly in need of long-term care tend to have worse health and have higher need of medical care than elderly without need for long-term care. Yet, characteristics associated with long-term care need can impede health care access: Higher levels of long-term care need come with physical and cognitive decline such as frailty and memory loss. Yet, it has not been investigated whether level of long-term care need is related to medical care utilization. METHODS:We investigated the association between the level of long-term care and medical specialist utilization among nursing home residents and home care recipients. We applied zero-inflated Poisson regression with robust standard errors based on a sample of statutory health insurance members. The sample consisted of 100.000 elderly over age 60. We controlled for age, gender, morbidity and mortality, residential density, and general practitioner utilization. RESULTS:We found a strong gradient effect of the level of long-term care for 9 out of 12 medical specialties: A higher level of long-term care need was associated with a lower probability of having a medical specialist visit. Yet, we did not find clear effects of the level of long-term care need on the intensity of medical specialist care. These findings were similar for both the nursing home and home care setting. CONCLUSION:The findings indicate that inequalities in medical specialist utilization exist between elderly with differing levels of long-term care need because differences in morbidity were controlled for. Elderly with higher need of long-term care might face more access barriers to specialist medical care.

SUBMITTER: Schulz M

PROVIDER: S-EPMC7006141 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Differences in medical specialist utilization among older people in need of long-term care - results from German health claims data.

Schulz Maike M Czwikla Jonas J Tsiasioti Chrysanthi C Schwinger Antje A Gand Daniel D Schmiemann Guido G Schmidt Annika A Wolf-Ostermann Karin K Kloep Stephan S Heinze Franziska F Rothgang Heinz H

International journal for equity in health 20200207 1

<h4>Background</h4>Elderly in need of long-term care tend to have worse health and have higher need of medical care than elderly without need for long-term care. Yet, characteristics associated with long-term care need can impede health care access: Higher levels of long-term care need come with physical and cognitive decline such as frailty and memory loss. Yet, it has not been investigated whether level of long-term care need is related to medical care utilization.<h4>Methods</h4>We investigat ...[more]

PMID: 32033606

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Differences in medical specialist utilization among older people in need of long-term care - results from German health claims data.

Publications

Differences in medical specialist utilization among older people in need of long-term care - results from German health claims data.

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