Table 3.
Direction of effects of the association between long-term care setting and medical specialist utilization
| Medical specialty | Nursing home residents | Home care recipients | Given at least one diagnosis from the following disease categories | ||
|---|---|---|---|---|---|
| Reference group: Older people without need of long-term care | |||||
| No visit | Number of visits | No visit | Number of visits | ||
| Internal medicine | + | – | + | + | Arthropathy, coronary disease, diabetes mellitus, heart disease, hypertension, mono- and polyneuropathy, metabolic disorders |
| + | – | + | o | Cerebrovascular disease, respiratory disease | |
| + | o | + | + | Nutrition-related disease, intestinal disease, renal failure, thyroid disorders | |
| + | o | + | o | Palsy/paresis, Parkinson’s disease | |
| + | + | Motor impairmenta | |||
| Cardiology | + | – | + | o | Coronary disease, heart disease, hypertension |
| Ophthalmology | + | o | + | + | Diseases of the eye |
| Orthopedics | + | – | + | – | Arthropathy, osteopathy and chondropathy, spinal disease |
| + | + | Motor impairmenta | |||
| + | o | + | o | Injury | |
| Gynecology | + | o | + | o | Urinary tract disease, disorders of female genital tract |
| Urology | + | o | + | o | Urinary tract disease |
| o | o | + | o | Prostate disease | |
| Surgery | o | o | o | o | Skin disease, injury |
| Dermatology | + | o | + | o | Bedsore/decubitus |
| o | o | + | o | Skin disease | |
| Otolaryngology | o | + | + | – | Diseases of the ear |
| Nephrology | + | o | o | + | Renal failure |
| Pneumology | + | o | + | o | Respiratory disease |
| Psychiatry /Neurology | – | + | – | + | Dementia-related disease |
| o | + | – | + | Depression | |
| – | + | o | + | Palsy/paresis, Parkinson’s disease, cerebrovascular disease | |
| – | + | o | o | Neuroses, mental disorders and disorders due to psychoactive substance use, delusional/personality disorders | |
| – | + | + | + | Mono- and polyneuropathy | |
Alpha level: SE Standard error, control variables in the model: mortality, gender and age (in groups), general practitioner visits, residential density; pseudo R2 ranges from 0.015 (otolaryngology utilization given an eye disease) to 0.208 (orthopedist utilization given motor impairment); nursing home residents n = 9700, home care recipients = 5100
autilization of orthopedics and internal medicine in case of diagnosed motor impairment was assessed by logistic regression not by zero-inflated Poisson
+ indicates higher probability of no visit/higher number of visits than reference group
- indicates lower probability of no visit/higher number of visits than reference group
o indicates no significant difference compared with reference group