Abstract
Background
Follow-up studies on the association between functional status and use of health care
services among the older people are scarce and have studied only a few types of service.
Objective
To examine prospectively the relationship between limitation in instrumental activities
of daily living (IADL) and utilization of a wide variety of health care services among
older adults in Spain.
Methods
Prospective study from 2001 to 2003 of a cohort of 2806 persons, representative of
the non-institutionalized Spanish population aged 60 years and over. Limitation in
IADL was measured in 2001 using the Lawton and Brody's test. Data on the use of health
care services were collected in 2003 and classified into home services (home visits
by physicians and nurses) and non-home services (visits to primary care physicians,
visits to hospital specialists, hospital admissions, emergency care, and influenza
vaccination). Analyses were performed with logistic regression and adjusted for the
main confounders.
Results
Compared to men with no limitation in IADL, a higher percentage of those with limitation
in one IADL in 2001 made use of both home (odds ratio [OR] 2.64; 95% confidence interval
[95% CI] 1.73–4.03) and non-home services (OR 2.02; 95% CI 1.04–3.93) in the period
2001–2003. Limitation in one IADL among women was associated with a greater utilization
of home services (OR 1.50; 95% CI 1.05–2.14) and visits to hospital specialists (OR
1.61; 95% CI 1.21–2.15). In women, however, a greater number of limited IADL at baseline
was inversely associated with visits to primary care physicians in the 2-year follow-up
(p for linear trend <0.001).
Conclusion
Population aging will increase the demand for health services in general, and for
home services in particular.
Keywords
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Article info
Publication history
Published online: October 16, 2007
Accepted:
September 18,
2007
Received in revised form:
September 14,
2007
Received:
July 2,
2007
Identification
Copyright
© 2007 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
