Influence of demographic structure on health services use by urban older adult population in Madrid Region (Spain)

PRIETO FLORES, M.E.; FERNANDEZ-MAYORALAS, G.; ROJO-PEREZ, F.; RODRIGUEZ-RODRIGUEZ, V.; ROJO-ABUIN, J. M.; AGUILAR, L.

Congreso; 4th International Conference on Urban Health; 2005

Introduction. More than 95% of the population in Madrid Region live in urban municipalities, and 31% are 50 years and over (urban older adult population). National Health System provides universal coverage, except for dental services. This communication describes (within a wider research on Quality of Life in the Region) the relationship between the study population structure and health services use.Methods. Database: 2003 National Health Survey (Ministry of Health www.msc.es). Two thousand interviews were performed among Madrid population (0.04% of the whole); 593 corresponded to older adults (0.04% of the 1.7 million aged 50 years and over). Study sample constitutes 95.3% (565 out of 593) of those older adults, who live in urban areas. Demographic structure (by age and gender) of this population in relation to health services use (medical consultations, dentist visits, emergence services, hospitalisation) was studied using General Linear Model Univariate procedure. A p<0.005 was considered significant.Results. From the study sample (n=565), urban adult aged 50 years and over show the following structure: 51% correspond to 50-64 years (n=285); 39% to 65-79 years (n=222); and 10% to 80 years and more (n=58). With respect to gender: 40% were males (n=225) vs 60% females (n=340). According to the three age groups, dentist visits (19% of the population studied: 22%, 16% and 17%, of each age group, respectively) and medical consultations (33% of the population: 28%, 37% and 45%, of each age group) were not associated with age (p>0.005), while age was associated  with emergence services use (26% of the population: 21%, 28% and 45%, of each age group) and hospitalisation (17% of the population: 13%, 20% and 31%, of each age group) (p<0.005 and p<0.001, for each health service). In relation to gender (males vs females), no association (p>0.005) was found with respect to dentist visits (18% vs 20%), medical consultations (29% vs 36%), and emergence services use (26% vs 26%), while an association (p=0.005) was found according to hospitalisation (20% vs 16%). Age and gender interaction effect on health services use was not found (p>0.005), but a trend towards hospitalisation (p=0.04) could be considered.Conclusions. Demographic structure of urban older adults is associated with two of the four health services use studied. A relationship between age and hospital services use (emergence units and hospitalisation), but not with out-hospital services (medical and dentist consultations), was found. In addition to age, gender also contributes to explain hospitalisation.