Perceived control as a buffer in the use of health care services

Gerontologists are increasingly interested in the notion of perceived personal control because such perceptions can be threatened by age-related changes such as declining health and the loss of loved ones. Although a great deal is known about the central role of perceived control in healthy, successful aging, less is known about its potential role in specific contexts such as the use of health services. Our study examined the link between perceived control and patterns of health service use among older individuals with arthritis. We assessed perceived control during an interview, using both a domain-specific and a global measure, and considered health service use in the subsequent year. Even after statistically adjusting for age and morbidity, individuals who perceived low levels of control subsequently were found to use more health services than their high-control counterparts; they visited their physicians more often, had more laboratory tests, and stayed longer in the hospital. This was true, however, only for individuals who had also reported that their arthritis restricted the things they were able to do. Various interpretations are considered, including the possibility that patients with low perceived control are inefficient users of health services or that patients with high perceived control experience a deficiency in health care.