title: Which factors affect health care use among older Germans? Results of the German ageing survey.
abstract: It remains an open question how changes in predisposing, enabling, and need factors affect health care use. Consequently, we aimed to investigate how changes in these variables affect health care use in community-dwelling older persons longitudinally.
  
  
  
  Data from two waves of the German Ageing Survey (DEAS), a representative sample of the community-dwelling German population aged ≥40 years, was used. Predictors of visits to general practitioners and specialists as well as hospital stays during a 12-month period were analyzed by fixed effects regressions.
  
  
  
  Regressions revealed that the need factors 'self-rated health' and the number of chronic diseases affected all measures of health care use (except for the number of chronic diseases on hospital care). An increased duration of physical activities increased GP visits. A decrease of excess weight decreased the number of specialist visits.
  
  
  
  Our findings underline the importance of need factors for health care use. Virtually none of the predisposing factors nor enabling resources affected health care use. These findings might indicate that individuals in the second half of life use health care services adequately, i.e. when medically indicated.
authors.affiliation: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. a.hajek@uke.de.
authors.forename: André
authors.identifier: 0000-0002-6886-2745
authors.initials: A
authors.lastname: Hajek
authors.affiliation: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Jens-Oliver
authors.initials: JO
authors.lastname: Bock
authors.affiliation: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
mesh_terms: D000328:Adult; D000368:Aged; D015444:Exercise / Q000502:physiology; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D005858:Germany; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D057566:Self Report; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D015431:Weight Loss / Q000502:physiology
keywords: Andersen’s behavioral model; Health care use; Health care utilization; Longitudinal study; Older adults