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Aging, social capital, and health care utilization in Canada

机译:加拿大的老龄化,社会资本和医疗保健利用

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摘要

This paper examines relationships between aging, social capital, and healthcare utilization. Cross-sectional data from the 2001 Canadian Community Health Survey and the Canadian Census are used to estimate a two-part model for both GP physicians (visits) and hospitalization (annual nights) focusing on the impact of community- (CSC) and individual-level social capital (ISC). Quantile regressions were also performed for GP visits. CSC is measured using the Petris Social Capital Index (PSCI) based on employment levels in religious and community-based organizations [NAICS 813XX] and ISC is based on self-reported connectedness to community. A higher CSC/lower ISC is associated with a lower propensity for GP visits/higher propensity for hospital utilization among seniors. The part-two (intensity model) results indicated that a one standard deviation increase (0.13%) in the PSCI index leads to an overall 5% decrease in GP visits and an annual offset in Canada of approximately Dollars 225 M. The ISC impact was smaller; however, neither measure was significant in the hospital intensity models. ISC mainly impacted the lower quantiles in which there was a positive association with GP utilization, while the impact of CSC was strongest in the middle quantiles. Each form of social capital likely operates through a different mechanism: ISC perhaps serves an enabling role by improving access (e.g. transportation services), while CSC serves to obviate some physician visits that may involve counseling/caring services most important to seniors. Policy implications of these results are discussed herein.
机译:本文研究了老龄化,社会资本和医疗保健利用率之间的关系。来自2001年加拿大社区健康调查和加拿大人口普查的横断面数据用于估算全科医生(访问)和住院(每年晚上)的两部分模型,重点关注社区(CSC)和个人-级别的社会资本(ISC)。 GP访视也进行了分位数回归。 CSC是根据宗教和基于社区的组织的就业水平,使用Petris社会资本指数(PSCI)进行衡量的[NAICS 813XX],而ISC基于与社区的自我报告的连通性。较高的CSC /较低的ISC与老年人中GP访视的较低倾向/较高的医院利用倾向相关。第二部分(强度模型)结果表明,PSCI指数每增加一个标准差(0.13%),GP访视总体减少5%,加拿大的年度抵消额约为2.25亿美元。较小但是,这两种方法在医院强度模型中均不显着。 ISC主要影响与GP利用率呈正相关的较低分位数,而CSC的影响在中等分位数中最强。每种形式的社会资本都可能通过不同的机制运作:ISC可能通过改善获取机会(例如运输服务)来发挥推动作用,而CSC则可以消除一些医生访问,而这些访问可能涉及对老年人最重要的咨询/护理服务。本文讨论了这些结果的政策含义。

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