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

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The journal of nutrition, health & aging

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.

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Author information

Author notes

  1. Equal contributors.

Authors and Affiliations

  1. Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center, Hamburg-Eppendorf, Germany

    André Hajek, C. Brettschneider & H.-H. König

  2. Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg-Eppendorf, Germany

    H. van den Bussche & M. Scherer

  3. Institute of General Practice, Medical Faculty, Kiel University, Kiel, Germany

    H. Kaduszkiewicz

  4. Institute of General Practice, Hannover Medical School, Hannover, Germany

    A. Oey & B. Wiese

  5. Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany

    S. Weyerer & J. Werle

  6. Institute of General Practice, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany

    A. Fuchs & M. Pentzek

  7. Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany

    J. Stein, T. Luck & S. G. Riedel-Heller

  8. Department of Psychiatry, Technical University of Munich, Munich, Germany

    H. Bickel & E. Mösch

  9. Department of Psychiatry, University of Bonn, Bonn, Germany

    K. Heser & W. Maier

  10. Institute of General Practice and Family Medicine, Medical Faculty at the University of Bonn, Bonn, Germany

    M. Bleckwenn

  11. German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany

    W. Maier

Authors
  1. André Hajek
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  2. C. Brettschneider
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  3. H. van den Bussche
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  4. H. Kaduszkiewicz
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  5. A. Oey
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  7. S. Weyerer
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  8. J. Werle
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  9. A. Fuchs
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  10. M. Pentzek
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  11. J. Stein
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  12. T. Luck
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  13. H. Bickel
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  14. E. Mösch
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  15. K. Heser
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  16. M. Bleckwenn
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  17. M. Scherer
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  18. S. G. Riedel-Heller
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  19. W. Maier
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  20. H.-H. König
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Consortia

AgeCoDe & AgeQualiDe Study Groups

Corresponding author

Correspondence to André Hajek.

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Hajek, A., Brettschneider, C., van den Bussche, H. et al. Longitudinal Analysis of Outpatient Physician Visits in the Oldest Old: Results of the AgeQualiDe Prospective Cohort Study. J Nutr Health Aging 22, 689–694 (2018). https://doi.org/10.1007/s12603-018-0997-5

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  • DOI: https://doi.org/10.1007/s12603-018-0997-5

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