Association between purpose in life and healthcare use among women and men in Germany: cross-sectional analysis of the nationally representative German Socio-Economic Panel (GSOEP) study

Abstract

ObjectivesIt remains almost unknown whether purpose in life is associated with healthcare use (HCU) in general. Therefore, the goal of this study was to examine the association between purpose in life and HCU (in terms of frequency of outpatient physician visits and hospitalisation) stratified by sex.DesignCross-sectional study.Setting and participantsA representative sample of the general adult population in Germany (n=1238; collected from September 2020 to February 2021); taken from the innovation sample of the German Socio-Economic Panel.Outcome measuresThe frequency of outpatient physician visits in the past 3 months was used as first outcome measure. Hospitalisation in the last 12 months was used as the second outcome measure. Purpose in life was quantified by means of the subscale ‘purpose in life’ of the six-factor model of psychological well-being. Covariates were selected based on the Andersen model.ResultsAverage purpose in life equaled 4.5 (SD: 0.8; ranging on a scale from 1 to 6, with higher values indicating higher purpose in life). Adjusting for various potential confounders, regressions revealed that higher purpose in life was associated with an increased frequency of outpatient physician visits in the past 3 months among women (IRR 1.16, 95% CI:1.03 to 1.30), but not men (IRR 0.96, 95% CI 0.87 to 1.07). In contrast, higher purpose in life was associated with in an increased likelihood of hospitalisation among men (OR 1.40, 95% CI 1.02 to 1.93), but not women (OR 1.03, 95% CI 0.79 to 1.34).ConclusionEven after adjusting for various potential confounders, there was still a gender-specific association between higher purpose in life and increased HCU. This knowledge may assist in addressing individuals at risk for underuse or overuse of healthcare services.

Scoping review of outpatient health services utilization among women

“…In some other studies, a negative relationship was observed between smoking and the use of health services (Homaie Rad et al, 2015). Smoking was not linked to HSU in one research (Hajek and König, 2022).…”

“…, 2011; Esmailnasab et al. , 2014; André Hajek and König, 2022; Hansen et al , 2012; Hassanzadeh et al. , 2013; Tountas et al.…”

“…A review of studies showed that having a job could increase the use of health services (Hall et al, 2014;Htun et al, 2021). While two studies showed that having a job was associated with a decrease in the use of health services (Abaerei et al, 2017;Hajek and König, 2022;Hyun and Kan, 2022), but in the study by Qian et al (Qian et al, 2017). The rate of OHSU in the last 2 weeks was higher among unemployed women.…”

“…In some studies, aging was associated with a reduced chance of utilizing outpatient health services (Hall et al, 2014), and in others, aging was associated with an increased chance of utilizing health services (Abaerei et al, 2017;Araujo et al, 2017;Bastos et al, 2011;Qian et al, 2017). Also, some studies did not find a relationship between age and health services utilization (Hajek and König, 2022;Hassanzadeh et al, 2013;Homaie Rad et al, 2015;Janković et al, 2018;Tountas et al, 2011;Wiru et al, 2017).…”

“…Women who reported poor health status were more likely to use health services (Bastos et al, 2011;Bazie and Adimassie, 2017;Hajek and König, 2022;Janković et al, 2018;Qian et al, 2017).…”