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. 2018;22(6):689-694.
doi: 10.1007/s12603-018-0997-5.

Longitudinal Analysis of Outpatient Physician Visits in the Oldest Old: Results of the AgeQualiDe Prospective Cohort Study

A Hajek  1 , C Brettschneider, H van den Bussche, H Kaduszkiewicz, A Oey, B Wiese, S Weyerer, J Werle, A Fuchs, M Pentzek, J Stein, T Luck, H Bickel, E Mösch, K Heser, M Bleckwenn, M Scherer, S G Riedel-Heller, W Maier, H-H König
Affiliations

Longitudinal Analysis of Outpatient Physician Visits in the Oldest Old: Results of the AgeQualiDe Prospective Cohort Study

A Hajek et al. J Nutr Health Aging. 2018.

Abstract

Objectives: The aim of this study was to identify determinants of outpatient health care utilization among the oldest old in Germany longitudinally.

Design: Multicenter prospective cohort "Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)" (AgeQualiDe).

Setting: Individuals in very old age were recruited via GP offices at six study centers in Germany. The course of outpatient health care was observed over 10 months (two waves).

Participants: Primary care patients aged 85 years and over (at baseline: n=861, with mean age of 89.0 years±2.9 years; 85-100 years).

Measurements: Self-reported numbers of outpatient visits to general practitioners (GP) and specialists in the past three months were used as dependent variables. Widely used scales were used to quantify explanatory variables (e.g., Geriatric Depression Scale, Instrumental Activities of Daily Living Scale, or Global Deterioration Scale).

Results: Fixed effects regressions showed that increases in GP visits were associated with increases in cognitive impairment, whereas they were not associated with changes in marital status, functional decline, increasing number of chronic conditions, increasing age, and changes in social network. Increases in specialist visits were not associated with changes in the explanatory variables.

Conclusion: Our findings underline the importance of cognitive impairment for GP visits. Creating strategies to postpone cognitive decline might be beneficial for the health care system.

Keywords: Andersen’s behavioral model; Health care utilization; longitudinal study; oldest old; outpatient.

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Conflict of interest statement

Dr. Hajek has nothing to disclose. Dr. Brettschneider has nothing to disclose. Prof. Dr. van den Bussche has nothing to disclose. Prof. Dr. Kaduszkiewicz has nothing to disclose. Ms. Oey has nothing to disclose. Ms. Wiese has nothing to disclose. Prof. Dr. Weyerer has nothing to disclose. Dr. Werle has nothing to disclose. Ms. Fuchs has nothing to disclose. Dr. Pentzek has nothing to disclose. Dr. Stein has nothing to disclose. PD Dr. Luck has nothing to disclose. Dr. Bickel has nothing to disclose. Dr. Mösch has nothing to disclose. Dr. Heser has nothing to disclose. Dr. Bleckwenn has nothing to disclose. Prof. Dr. Scherer has nothing to disclose. Prof. Dr. Riedel-Heller has nothing to disclose. Prof. Dr. Maier has nothing to disclose. Prof. Dr. König has nothing to disclose.

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