title: [Health-care utilization in elderly (Spain 2006-2012): Influence of health status and social class].
abstract: OBJECTIVE
  to explore health-care utilization (primary and specialized health-care, hospitalizations, day hospital and emergency services) and overuse in elderly in Spain, considering the influence of health status, sex, social class and its temporal trend.
  
  
  METHODS
  cross sectional study in two phases.
  
  
  METHODS
  Spain.
  
  
  METHODS
  people surveyed in the National Health Surveys 2006 and 2011-12.
  
  
  METHODS
  Health status was measured using self-rated and diagnosed health (number and diagnoses). Social class was obtained from the last occupation of the main supporter (manual and non-manual workers). Logistic regression analyses were conducted adjusting by sex, age, health status, social class and year, obtaining its predictive capacity.
  
  
  RESULTS
  the percentage of elderly population with health-care utilization decreased during the period analyzed. Women who belonged to the manual workers category presented the highest prevalence of low health (low self-rated health in 2006: 70.6%). Low health status was associated with a higher utilization of health-care services. Self-rated health was a better predictor of health-care utilization and overuse than diagnosed health, getting the highest predictive capacity for specialized health-care (C = 0.676). Old people from low social class used with higher frequency primary health-care and emergency services. On the other hand, specialized health-care and day hospital were more used by high social classes.
  
  
  CONCLUSIONS
  inequalities in health and health-care utilization have been observed in elderly according social class. It is necessary to consider self-rated health as a health-care utilization predictor and to review our health-care services accessibility and equity.
authors.affiliation: Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, España; Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Santa Eulalia del Campo, Teruel, España. Electronic address: iaguilar@unizar.es.
authors.forename: Isabel
authors.initials: I
authors.lastname: Aguilar-Palacio
authors.affiliation: Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, España.
authors.forename: Patricia
authors.initials: P
authors.lastname: Carrera-Lasfuentes
authors.affiliation: Servicio de Geriatría, Hospital San José, Teruel, España.
authors.forename: Sofía
authors.initials: S
authors.lastname: Solsona
authors.affiliation: Centro de Salud de Santa Eulalia del Campo, Teruel, España.
authors.forename: M Teresa
authors.initials: MT
authors.lastname: Sartolo
authors.affiliation: Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, España; Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Santa Eulalia del Campo, Teruel, España.
authors.forename: M José
authors.initials: MJ
authors.lastname: Rabanaque
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D012923:Social Class; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology
keywords: Aged; Anciano; Clase social; Encuestas epidemiológicas; Health services; Health surveys; Salud percibida; Self-rated health; Servicios de salud; Social class