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

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Abstract

Objective

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.

Methods

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.

Results

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.

Conclusion

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.

Electronic supplementary material

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 34

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Inequalities in access to medical care by income in developed countries.

Eddy Van Doorslaer, Cristina Masseria, Xander Koolman (2006)

Most of the member countries of the Organization for Economic Cooperation and Development (OECD) aim to ensure equitable access to health care. This is often interpreted as requiring that care be available on the basis of need and not willingness or ability to pay. We sought to examine equity in physician utilization in 21 OECD countries for the year 2000. Using data from national surveys or from the European Community Household Panel, we extracted the number of visits to a general practitioner or medical specialist over the previous 12 months. Visits were standardized for need differences using age, sex and reported health levels as proxies. We measured inequity in doctor utilization by income using concentration indices of the need-standardized use. We found inequity in physician utilization favouring patients who are better off in about half of the OECD countries studied. The degree of pro-rich inequity in doctor use is highest in the United States and Mexico, followed by Finland, Portugal and Sweden. In most countries, we found no evidence of inequity in the distribution of general practitioner visits across income groups, and where it does occur, it often indicates a pro-poor distribution. However, in all countries for which data are available, after controlling for need differences, people with higher incomes are significantly more likely to see a specialist than people with lower incomes and, in most countries, also more frequently. Pro-rich inequity is especially large in Portugal, Finland and Ireland. Although in most OECD countries general practitioner care is distributed fairly equally and is often even pro-poor, the very pro-rich distribution of specialist care tends to make total doctor utilization somewhat pro-rich. This phenomenon appears to be universal, but it is reinforced when private insurance or private care options are offered.

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Who Cares? Toward an Integrated Theory of Volunteer Work

John Wilson, MARC A. MUSICK (1997)

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Formal volunteering as a protective factor for older adults' psychological well-being.

E Greenfield, N. F. Marks (2004)

Guided by interactional role theory and employing a resilience framework, this study aimed to investigate whether formal volunteering protects older adults with more role-identity absences in major life domains (partner, employment, and parental) from poorer psychological well-being. We used data from 373 participants, aged 65-74, in the 1995 National Survey of Midlife Development in the U.S. (MIDUS). Multivariate regression models estimated the effects of major role-identity absences, formal volunteering, and the interaction between major role-identity absences and volunteering on respondents' negative affect, positive affect, and purpose in life. Participants with a greater number of major role-identity absences reported more negative affect, less positive affect, and less purpose in life. Being a formal volunteer was associated with more positive affect and moderated the negative effect of having more major role-identity absences on respondents' feelings of purpose in life. Consistent with previous studies, findings indicate that having more role-identity absences constitutes a risk factor for poorer psychological well-being. Results further demonstrate that being a formal volunteer can protect older adults with a greater number of major role-identity absences from decreased levels of purpose in life. The findings suggest that associations between volunteering and psychological well-being might be contingent upon the volunteer's role-identity status and the dimension of psychological well-being examined.

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Author and article information

Contributors

Maike Flennert: Maike_Flennert@web.de

Hans-Helmut König: h.koenig@uke.de

André Hajek: a.hajek@uke.de

Journal

Journal ID (nlm-ta): BMC Health Serv Res

Journal ID (iso-abbrev): BMC Health Serv Res

Title: BMC Health Services Research

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6963

Publication date (Electronic): 15 January 2019

Publication date PMC-release: 15 January 2019

Publication date Collection: 2019

Volume: 19

Electronic Location Identifier: 39

Affiliations

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

Article

Publisher ID: 3867

DOI: 10.1186/s12913-019-3867-x

PMC ID: 6334381

PubMed ID: 30646900

SO-VID: 11ed8d91-f448-4a18-b6e0-7298e36971b1

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), 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 ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 3 November 2018

Date accepted : 3 January 2019

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: volunteering,volunteer,health care use,health care utilization,gp visits,specialist visits,hospitalization,longitudinal study

Data availability:

ScienceOpen disciplines: Health & Social care

Keywords: volunteering, volunteer, health care use, health care utilization, gp visits, specialist visits, hospitalization, longitudinal study

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

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Abstract

Objective

Methods

Results

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Electronic supplementary material

Related collections

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Most cited references 34

Inequalities in access to medical care by income in developed countries.

Who Cares? Toward an Integrated Theory of Volunteer Work

Formal volunteering as a protective factor for older adults' psychological well-being.

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