title: Life events and daily hassles and uplifts as predictors of hospitalization and outpatient visitation.
abstract: Increased occurrence of major life events and daily "hassles" and "uplifts" have been shown to be associated with several measures of health status and health care utilization. In order to test for such an association with hospital admission, a prospective study was designed. Navajo Indians presenting for either inpatient or outpatient health care at a U.S. Indian Health Service facility were questioned regarding the occurrence of major life events in the preceding six months and of hassles and uplifts in the preceding week. Two years later the subsequent numbers of outpatient visits and of hospital admissions were determined for each subject. An increased number of either major life events (relative risk 1.66) or daily hassles and uplifts (relative risk 1.87) was found to be associated with an increased risk of hospital admission. The effects of major and daily life events were additive on the risk of admission. In addition, hassles were predictive of subsequent outpatient utilization. While further demonstrating the influence of major and daily life occurrences on health care utilization, this study also shows their importance in an additional cultural setting.
authors.affiliation: Department of Family Medicine, Case Western Reserve University, Cleveland, OH 44106.
authors.forename: R
authors.initials: R
authors.lastname: Williams
authors.forename: S J
authors.initials: SJ
authors.lastname: Zyzanski
authors.forename: A L
authors.initials: AL
authors.lastname: Wright
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D005544:Forecasting; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008016:Life Change Events; D008875:Middle Aged; D009516:New Mexico; D011446:Prospective Studies