title: Use of hospital services, religious attendance, and religious affiliation.
abstract: BACKGROUND
  We examined the relationship between religious attendance, religious affiliation, and use of acute hospital services by older medical patients.
  
  
  METHODS
  Religious affiliation (n = 542) and church attendance (n = 455) were examined in a consecutive sample of medical patients aged 60 or older admitted to Duke University Medical Center. Information on use of acute hospital services during the year before admission and length of the current hospital stay was collected. Frequency of church attendance and religious affiliation were examined as predictors of hospital service use, controlling for age, sex, race, education, social support, depressive symptoms, physical functioning, and severity of medical illness as covariates using logistic regression.
  
  
  RESULTS
  Patients who attended church weekly or more often were significantly less likely in the previous year to have been admitted to the hospital, had fewer hospital admissions, and spent fewer days in the hospital than those attending less often; these associations retained their significance after controlling for covariates. Patients unaffiliated with a religious community, while not using more acute hospital services in the year before admission, had significantly longer index hospital stays than those affiliated. Unaffiliated patients spent an average of 25 days in the hospital, compared with 11 days for affiliated patients; this association strengthened when physical health and other covariates were controlled.
  
  
  CONCLUSIONS
  Participation in and affiliation with a religious community is associated with lower use of hospital services by medically ill older adults, a population of high users of health care services. Possible reasons for this association and its implications are discussed.
authors.affiliation: Center for the Study of Religion/Spirituality and Health, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: H G
authors.initials: HG
authors.lastname: Koenig
authors.forename: D B
authors.initials: DB
authors.lastname: Larson
mesh_terms: D000368:Aged; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008602:Mental Healing; D008875:Middle Aged; D009657:North Carolina; D012068:Religion and Medicine