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      The association between voluntary work and health care use among older adults in Germany

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          While most studies focused on the relation between volunteering and health-related outcomes, little attention has been given on the association between volunteering and the use of health care services. Thus, with this analysis we aimed at exploring whether and how the voluntary work of older adults is related to the utilization of health care services in Germany.


          The analysis was based on data from the German Ageing Survey (DEAS), a nationally representative, longitudinal study of the German population aged 40 years and older. Focusing on volunteering, data from the waves 2002, 2008 and 2011 was used. Voluntary work in groups and organizations (yes/no) was used as explanatory variable. To quantify health care utilization, visits to general practitioners and specialists as well as nights in the hospital in the past 12 months were used. Fixed effects regressions were applied to estimate the association between volunteering and the outcome variables.


          Regressions revealed that the onset of volunteer involvement was associated with an increase in specialist visits, whereas volunteering did not affect visits to general practitioners and the probability of hospitalization significantly.


          Our findings emphasize the relation between volunteering and specialist visits. Future research is needed to examine the impact of volunteering on health care use, taking more detailed information regarding the specific context of volunteering as well as personality factors and personal background into consideration. This might be reasonable in advancing the knowledge about this association and in developing planned interventions.

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          The online version of this article (10.1186/s12913-019-3867-x) contains supplementary material, which is available to authorized users.

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          Most cited references 43

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          The Behavioral Model of Health Services Use was initially developed over 25 years ago. In the interim it has been subject to considerable application, reprobation, and alteration. I review its development and assess its continued relevance.
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              Social relationships and health


                Author and article information

                ISNI 0000 0001 2180 3484, GRID grid.13648.38, Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, , University Medical Center Hamburg-Eppendorf, ; Martinistr. 52, 20246 Hamburg, Germany
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                15 January 2019
                15 January 2019
                : 19
                30646900 6334381 3867 10.1186/s12913-019-3867-x
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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                © The Author(s) 2019


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