Influence of living arrangements on health services utilisation in Australia
M. Afzal Mahmood A C , Anna E. Bauze A B , Justin T. Lokhorst A , Peng Bi A and Arthur Saniotis AA Discipline of Public Health, University of Adelaide, Level 9, 10 Pulteney Street, Adelaide, SA 5005, Australia. Email: lokhorst@adam.com.au; peng.bi@adelaide.edu.au; arthur.saniotis@adelaide.edu.au
B Communicable Disease Management and Policy Section, Biosecurity and Disease Control Branch, Australian Government Department of Health and Ageing, Canberra, ACT 2601, Australia. Email: annabauze@hotmail.com
C Corresponding author. Email: afzal.mahmood@adelaide.edu.au
Australian Health Review 36(1) 34-38 https://doi.org/10.1071/AH10920
Submitted: 17 May 2010 Accepted: 12 April 2011 Published: 9 December 2011
Abstract
Background. The number of people living alone is increasing markedly. Others live as couples only, couples with child(ren) and single adult with child(ren). Health service utilisation could differ for people in different living arrangements as a result of varying levels of risk factors, health status, access to informal care and decision-making for accessing care.
Objective. To identify the association between living arrangements and health service use.
Methods. The Australian Bureau of Statistics’ National Health Survey 2001 data for people 18–65 years old were analysed for household composition and service use.
Results. People in various household types differ in terms of their overall use of health services and their use of services by general practitioners. Sex, rurality, socioeconomic status and status of heart condition significantly influenced the use of health services.
Conclusion. There are implications for health services provision and planning within the context of rapid changes in living arrangements. Additional research is required to explore the reasons to such differences, level of access to informal care, healthcare decision-making processes and consequences of under- or over-utilisation of services.
What is known about the topic? Health service use is influenced by the disease burden and pattern, demography, economic factors, access to social support, quality of care and satisfaction with standards of care. These factors may influence access to and use of care.
What does this paper add? This research points to the potential role of living arrangements on health services use. Many people now live alone and may not have access to informal care, and access to health information and education. People in different living arrangements appear to have different health service use.
What are the implications for practitioners? Practitioners, in both primary care and acute care sectors, need to consider that patients, including younger people, may not have access to informal care, may present with delays and may not have the needed adequate support during convalescence. Health education needs to consider that people in different living arrangements may be exposed to different levels of risk factors in terms of their healthcare use.
References
[1] Future Living Arrangements. In: Year Book Australia, 2006. Australian Bureau of Statistics; 2006. Cat. 1301.0. 2006. Available at http://www.abs.gov.au/Ausstats/ABS@.nsf/Previousproducts/1301.0Feature%20Article92006?opendocument&tabname=Summary&prodno=1301.0&issue=2006&num=&view= [verified 8 December 2009].[2] Weston R, Stanton D, Qu L, Soriano G. Australian families in transition: sociodemographic trends 1901–2001. Fam Matters 2001; 60 12–23.
[3] Qu L, Weston R, Kilmartin C. Children? No children? Effects of changing personal relationships on decisions about having children. Fam Matters 2000; 57 14–9.
[4] Health of South Australians – Health Related Actions. Australian Bureau of Statistics; 2006. Cat. 1345.4 – SA Stats, Dec 2006. Available at http://www.abs.gov.au/ausstats/abs@.nsf/2f762f95845417aeca25706c00834efa/11dc3426cb8475b6ca25724800113d8c!OpenDocument [verified 8 December 2009].
[5] Benzeval M. The self-reported health status of lone parents. Soc Sci Med 1998; 46 1337–53.
| The self-reported health status of lone parents.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1czivVGjsA%3D%3D&md5=7b73d9db5f924d126ef367cae7b55165CAS | 9665565PubMed |
[6] Brown GW, Moran PM. Single mothers, poverty and depression. Psychol Med 1997; 27 21–33.
| Single mothers, poverty and depression.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2s7mvVahsA%3D%3D&md5=a83aff541026edccb8e7ec1a20269f80CAS | 9122302PubMed |
[7] Grundy E, Sloggett A. Health inequalities in the older population: the role of personal capital, social resources and socio-economic circumstances. Soc Sci Med 2003; 56 935–47.
| Health inequalities in the older population: the role of personal capital, social resources and socio-economic circumstances.Crossref | GoogleScholarGoogle Scholar | 12593868PubMed |
[8] Takeda Y, Kawachi I, Yamagata Z, Hashimoto S, Matsumura Y, Oguri S, et al Multigenerational family structure in Japanese society: impacts on stress and health behaviours among women and men. Soc Sci Med 2004; 59 69–81.
| Multigenerational family structure in Japanese society: impacts on stress and health behaviours among women and men.Crossref | GoogleScholarGoogle Scholar | 15087144PubMed |
[9] Australia’s Welfare No. 6 2003. Canberra: AIHW; 2003. Cat. AUS-41.
[10] National Health Survey: Users’ Guide, 2001. Australian Bureau of Statistics; 2002. Cat. 4363.0.55.001. Available at http://www.abs.gov.au/Ausstats/abs@.nsf/0/11B070B0D4AF5BAECA256D32001B04B4?Open [verified 20 July 2004].
[11] Australia’s Health 2004. Canberra: AIHW; 2004. Cat. AUS-44.
[12] Wolter KM. Introduction to variance estimation. New York: Springer-Verlag; 1985.
[13] Huber CA, Baumeister SE, Ladwig K, Mielck A. Living with a partner and health care use – results from the MONICA survey Augsburg in Southern Germany. Psychosoc Med. 2007; 4: 13. Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736524/ [verified 10 February 2010].
[14] Kouzis AC, Eaton WW. Absence of social networks, social support and health services utilization. Psychol Med 1998; 28 1301–10.
| Absence of social networks, social support and health services utilization.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M%2FntFCgtw%3D%3D&md5=cb3c34e8bce89c13fc40dca439e54c08CAS | 9854271PubMed |
[15] Walker AE. Multiple chronic diseases and quality of life: patterns emerging from a large national sample, Australia. Chronic Illn 2007; 3 202–18.
| Multiple chronic diseases and quality of life: patterns emerging from a large national sample, Australia.Crossref | GoogleScholarGoogle Scholar | 18083677PubMed |
[16] Ford ES, Ahluwalia IB, Galuska DA. Social relationships and cardiovascular risk factors: findings from the Third National Health and Nutrition Examination Survey. Prev Med 2000; 30 83–92.
| Social relationships and cardiovascular risk factors: findings from the Third National Health and Nutrition Examination Survey.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c7isVSksg%3D%3D&md5=d216b182e6824f56c67e700ff93e787fCAS | 10656835PubMed |
[17] Ren XS, Skinner K, Lee A, Kazis L. Social support, social selection and self-assessed health status: results from the veterans health study in the United States. Soc Sci Med 1999; 48 1721–34.
| Social support, social selection and self-assessed health status: results from the veterans health study in the United States.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1MzjtFyqtQ%3D%3D&md5=fa41a2e4a63c2d14360f23a80d99025bCAS | 10405011PubMed |
[18] Hirst M. Trends in informal care in Great Britain during the 1990s. Health Soc Care Community 2001; 9 348–57.
| Trends in informal care in Great Britain during the 1990s.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD387htlSisQ%3D%3D&md5=09504d317d1850d9db772a0412c81637CAS | 11846813PubMed |
[19] Anson O. Living arrangements and women’s health. Soc Sci Med 1988; 26 201–8.
| Living arrangements and women’s health.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL1c7lvFaktg%3D%3D&md5=7fbac977429419744ad827e4a3f5480aCAS | 3347847PubMed |
