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Social relationships and physician utilization among older adults—A systematic review

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  • Daniel Bremer
  • Laura Inhestern
  • Olaf von dem Knesebeck

Abstract

Background: In older age health needs and demand for health services utilization increase. Individual’s social relationships can play a decisive role regarding the utilization of outpatient health care services. This systematic review examines the associations of structural and functional dimensions of social relationships with outpatient health services use of older adults. Methods: The databases PubMed, CINAHL, SocINDEX, PsycINFO, International Bibliography of the Social Sciences (IBSS), Sociological Abstracts, and Applied Social Sciences Index and Abstracts (ASSIA) were searched in February 2016. The methodological and reporting quality of the articles was assessed and the results were synthesized descriptively and systematically. Results: Out of 1.392 hits, 36 articles (35 studies) were included in the systematic review. The methodological and reporting quality of the included articles was reasonable. Various structural and functional characteristics of social relationships were associated with the use (yes/no) and the frequency of using outpatient care among older adults. The majority of the associations between structural dimensions of social relationships and the use of physicians were positive and moderate in strength. The associations between functional dimensions of social relationships and the probability of using physician services were inconsistent and varied in strength. For the most part, social relationship variables assigned to the structural dimension were positively and weakly to moderately associated with the frequency of physician visits. Functional aspects of social relationships also tended to have positive associations with the frequency of physician utilization. The associations were weak to moderate in strength. Conclusions: Measuring social relationships and their influence on health services use is a challenging methodological endeavor indicated by the inconclusive results. The results suggest that the outpatient care utilization behavior of older individuals being structurally and functionally integrated in social relationships is different to older adults being socially isolated or having no social support. All in all, the current status of quantitative data was insufficient. Future health services research should accentuate social ties in more detail, especially according to quality aspects of social relationships.

Suggested Citation

  • Daniel Bremer & Laura Inhestern & Olaf von dem Knesebeck, 2017. "Social relationships and physician utilization among older adults—A systematic review," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-20, September.
    • Handle: RePEc:plo:pone00:0185672
    DOI: 10.1371/journal.pone.0185672
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    References listed on IDEAS

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    1. Laporte, Audrey & Nauenberg, Eric & Shen, Leilei, 2008. "Aging, social capital, and health care utilization in Canada," Health Economics, Policy and Law, Cambridge University Press, vol. 3(4), pages 393-411, October.
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    1. Daniel Bremer & Daniel Lüdecke & Olaf von dem Knesebeck, 2019. "Social Relationships, Age and the Use of Preventive Health Services: Findings from the German Ageing Survey," IJERPH, MDPI, vol. 16(21), pages 1-14, November.

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