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Marital status and health care utilization
I M Joung1, J B van der Meer, J P Mackenbach
1Department of Public Health, Erasmus University Rotterdam, The Netherlands.
International Journal of Epidemiology
|June 1, 1995
Summary
Marital status influences healthcare use, with education and health status partially explaining differences. Unexplained variations persist, particularly for divorced individuals, highlighting the need for further research into socio-psychological factors and living arrangements.
Area of Science:
- Health Services Research
- Sociology of Health
- Epidemiology
Background:
- Previous studies on healthcare utilization by marital status often lack comprehensive control for confounding variables beyond age and sex.
- Understanding the influence of socio-demographic factors and health status on healthcare access is crucial for equitable health service delivery.
Purpose of the Study:
- To determine the extent to which socio-demographic variables (beyond age and sex) confound the relationship between marital status and healthcare utilization.
- To assess the degree to which differences in health status by marital status explain variations in healthcare utilization.
Main Methods:
- Utilized baseline data from the Longitudinal Study on Socio-Economic Differences in the Utilization of Health Services (n=2662, aged 25-74) in the Netherlands.
- Employed multiple logistic regression to analyze healthcare utilization (general practitioner, specialist, hospital admission, prescription medicines) by marital status.
- Controlled for socio-demographic variables (education, urbanization, religion, country of birth) and health indicators.
Main Results:
- Educational level significantly confounds the association between marital status and healthcare utilization.
- Health status differences largely explain higher utilization among widowed and divorced individuals, but not lower utilization among the never married.
- Unexplained disparities in healthcare utilization by marital status remain; divorced individuals showed higher hospitalization rates (OR=1.53) than married individuals after adjustments.
Conclusions:
- Healthcare utilization disparities by marital status persist even after accounting for socio-demographic confounding and health status differences.
- Further research is warranted to explore the impact of socio-psychological variables and living arrangements on these unexplained utilization differences.