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Does More Health Care Improve Health Among Older Adults? A Longitudinal Analysis
Ezra Golberstein, BA
University of Michigan School of Public Health, Ann Arbor
Jersey Liang, PhD
University of Michigan School of Public Health, Ann Arbor, jliang{at}umich.edu
Ana Quiñones, MS
University of Michigan School of Public Health, Ann Arbor
Fredric D. Wolinsky, PhD
College of Public Health, University of Iowa, and Center for Research on the Implementation of Innovative Strategies in Practice, Iowa City Veterans A fairs Medical Center, Iowa City
Objectives: This research assesses the association of health services use with subsequent physical health among older Americans, adjusting for the confounding between health care use and prior health. Method: Longitudinal data are from the Survey on Assets and Health Dynamics Among the Oldest Old (AHEAD). Linear and logistic regressions are used to model the linkages between medical care use and health outcomes, including self-rated health, functional limitations, and mortality. Results: There is limited evidence that increased health care use is correlated with improved subsequent health. Increased use of medical care is largely associated with poorer health outcomes. Moreover, there are no significant interaction effects of health care use and baseline health on Activities of Daily Living and Instrumental Activities of Daily Living, despite the existence of a significant but very small interaction effect on self-rated health. Conclusions: The findings have implications for the quality of care delivered by the American health care system.
Key Words: older Americans • health outcomes • quality of care
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Journal of Aging and Health, Vol. 19, No. 6,
888-906 (2007)
DOI: 10.1177/0898264307308338
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