Utilization of medical rehabilitation services among older Poles: results of the PolSenior study

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Abstract

Background

Rehabilitation tailored to older adults’ needs might improve their functional performance and quality of life, as well as increase social participation. The aim of the study was to evaluate the use of medical rehabilitation services among older Poles in relation to socio-economic and health-related determinants.

Materials and methods

Data regarding medical rehabilitation were obtained from the nationwide, multidisciplinary PolSenior project (2007–2012) conducted on representative sample of 4813 respondents (48.3% women) aged 65+ years. Socio-economic status, physical functioning, falls, chronic pain, and formal disability occurrence, as well as self-rated health were accounted for.

Results

One in six respondents (18.9% women vs. 15.8% men, p < 0.005) underwent medical rehabilitation during 12 months prior to the survey. Respondents mostly received electrotherapy or light radiation therapy (61.3%). Multivariate logistic regression analysis revealed that women aged 80+ years and men aged 90+ years had a significantly lower chance of using rehabilitation services compared to the youngest study participants (65–69 y.o.). City dwellers used rehabilitation services nearly twice as frequently as rural dwellers. Respondents with university education level were most likely to take part in these services. Dependence in IADL decreased participation in medical rehabilitation, while formal disability and chronic pain promoted utilization of rehabilitation services.

Conclusions

Younger age, city dwelling, higher education, functional independence, formal disability certificate, and chronic pain increased participation in medical rehabilitation. Such results of the study should be considered in planning actions towards reducing health inequalities at the national level and promoting health and well-being among older adults.

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Most cited references 26

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Massage therapy research review.

Tiffany Field (2016)

In this review, massage therapy has been shown to have beneficial effects on varying conditions including prenatal depression, preterm infants, full-term infants, autism, skin conditions, pain syndromes including arthritis and fibromyalgia, hypertension, autoimmune conditions including asthma and multiple sclerosis, immune conditions including HIV and breast cancer and aging problems including Parkinson's and dementia. Although many of the studies have involved comparisons between massage therapy and standard treatment control groups, several have compared different forms of massage (e.g. Swedish versus Thai massage), and different active therapies such as massage versus exercise. Typically, the massage therapy groups have experienced more positive effects than the control or comparison groups. This may relate to the massage therapy providing more stimulation of pressure receptors, in turn enhancing vagal activity and reducing cortisol levels. Some of the researchers have assessed physical, physiological and biochemical effects, although most have relied exclusively on self-report measures. Despite these methodological problems and the dearth of research from the U.S., the massage therapy profession has grown significantly and massage therapy is increasingly practiced in traditional medical settings, highlighting the need for more rigorous research.

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Income-related inequalities and inequities in health care services utilisation in 18 selected OECD countries.

Marion Devaux (2015)

A key policy objective in OECD countries is to achieve adequate access to health care for all people on the basis of need. Previous studies have shown that there are inequities in health care services utilisation (HCSU) in the OECD area. In recent years, measures have been taken to enhance health care access. This paper re-examines income-related inequities in doctor visits among 18 selected OECD countries, updating previous results for 12 countries with 2006-2009 data, and including six new countries. Inequalities in preventive care services are also considered for the first time. The indirect standardisation procedure is used to estimate the need-adjusted HCSU and concentration indexes are derived to gauge inequalities and inequities. Overall, inequities in HCSU remain present in OECD countries. In most countries, for the same health care needs, people with higher incomes are more likely to consult a doctor than those with lower incomes. Pro-rich inequalities in dental visits and cancer screening uptake are also found in nearly all countries, although the magnitude of these varies among countries. These findings suggest that further monitoring of inequalities is essential in order to assess whether country policy objectives are achieved on a regular basis.

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Rehabilitation: The health strategy of the 21st century.

Gerold Stucki, Jerome Bickenbach, Christoph Gutenbrunner … (2018)

There is strong evidence that population ageing and the epidemiological transition to a higher incidence of chronic, non-communicable diseases will continue to profoundly impact societies worldwide, putting more pressure on healthcare systems to respond to the needs of the people they serve. These trends argue for the need to address what matters to people about their health: limitations in their functioning that affect their day-to-day actions and goals in life. From its inception, rehabilitation, 1 of the 4 health strategies identified in the Declaration of Alma Ata in 1978, has had functioning as its outcome of interest. Its practitioners are from fields that include physical and rehabilitation medicine, occupational therapy, physiotherapy, speech and language therapy, orthotics and prosthetics, psychology, and evaluators of functioning interventions, including assistive technologies. Demographic and epidemiological trends suggest that the key indicators of the health of populations will be not merely mortality and morbidity, but functioning as well. This, in turn, suggests that the primary focus of healthcare will need to respond to actual healthcare demands generated by the need for long-term management of chronic conditions, including, in particular, the scaling up and strengthening of rehabilitation. This is the case for thinking that rehabilitation will become the key health strategy of the 21st century.

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Author and article information

Contributors

Aleksandra Szybalska:

ORCID: http://orcid.org/0000-0002-8943-6948

a.szybalska@iimcb.gov.pl

Journal

Journal ID (nlm-ta): Eur Geriatr Med

Journal ID (iso-abbrev): Eur Geriatr Med

Title: European Geriatric Medicine

Publisher: Springer International Publishing (Cham )

ISSN (Print): 1878-7649

ISSN (Electronic): 1878-7657

Publication date (Electronic): 20 June 2018

Publication date PMC-release: 20 June 2018

Publication date (Print): 2018

Volume: 9

Issue: 5

Pages: 669-677

Affiliations

[1 ]GRID grid.419362.b, International Institute of Molecular and Cell Biology in Warsaw, ; 4 Ks. Trojdena Street, 02-109 Warsaw, Poland

[2 ]ISNI 0000000113287408, GRID grid.13339.3b, Department of Geriatrics, , Medical University of Warsaw, ; Warsaw, Poland

[3 ]GRID grid.449495.1, Department of Recreation Methodology, Faculty of Tourism and Recreation, , Jozef Pilsudski University of Physical Education in Warsaw, ; Warsaw, Poland

[4 ]ISNI 0000 0001 2198 0923, GRID grid.411728.9, Department of Internal Medicine and Oncological Chemotherapy, Medical Faculty in Katowice, , Medical University of Silesia, ; Katowice, Poland

[5 ]ISNI 0000 0004 0620 8558, GRID grid.415028.a, Department of Human Epigenetics, , Mossakowski Medical Research Centre, PAS, ; Warsaw, Poland

[6 ]ISNI 0000 0001 2205 7719, GRID grid.414852.e, Department of Geriatrics and Gerontology, , Medical Centre of Postgraduate Education, ; Warsaw, Poland

[7 ]ISNI 0000 0001 2165 3025, GRID grid.8267.b, Department of Geriatrics, , Medical University of Lodz, ; Lodz, Poland

[8 ]ISNI 0000 0001 2162 9631, GRID grid.5522.0, Department of Internal Medicine and Gerontology, , Jagiellonian University Medical College, ; Cracow, Poland

Author information

Aleksandra Szybalska http://orcid.org/0000-0002-8943-6948

Article

Publisher ID: 77

DOI: 10.1007/s41999-018-0077-8

PMC ID: 6153710

PubMed ID: 30294398

SO-VID: a0492f74-9dd0-4fea-badb-cb338fdf7b19

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.

History

Date received : 12 March 2018

Date accepted : 7 June 2018

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100004569, Ministerstwo Nauki i Szkolnictwa Wyższego;

Award ID: No. PBZ-MEIN-9/2/2006

Custom metadata

Keywords: rehabilitation medicine,aging,population-based study,disability,polsenior study,health inequalities

Data availability:

Keywords: rehabilitation medicine, aging, population-based study, disability, polsenior study, health inequalities

Utilization of medical rehabilitation services among older Poles: results of the PolSenior study

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Abstract

Background

Materials and methods

Results

Conclusions

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Journal of Health and Rehabilitation Sciences

Most cited references 26

Massage therapy research review.

Income-related inequalities and inequities in health care services utilisation in 18 selected OECD countries.

Rehabilitation: The health strategy of the 21st century.

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Contributors

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