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- Title
Indicators of resilience and healthcare outcomes: findings from the 2010 health and retirement survey.
- Authors
Ezeamama, Amara; Elkins, Jennifer; Simpson, Cherie; Smith, Shaniqua; Allegra, Joseph; Miles, Toni; Ezeamama, Amara E; Smith, Shaniqua L; Allegra, Joseph C; Miles, Toni P
- Abstract
<bold>Objective: </bold>To test the hypothesis that higher levels of resilience indicators are associated with lower overall healthcare utilization (HCU) as well as improvements in self-rated health (SRH), we analyzed a representative sample of 4562 adults 50-70 years old enrolled in the US 2010 health and retirement survey.<bold>Methods: </bold>Multivariable logistic regression models estimated odds ratios (ORs) and 95 % confidence intervals (CIs) for high versus low resilience in relation to HCU and SRH improvements over 2 years. Resilience indicators included: cumulative lifetime adversity, social support, global mastery and domain-specific mastery. Cumulative lifetime adversity was defined as 0, 1-2, 3-4 or 5+ events. HCU included hospitalization (any vs. none) and physician visits (< 20 vs. ≥ 20) over 2 years.<bold>Findings: </bold>Hospitalization odds declined by 25 % (OR 0.75, 95 %CI 0.64-0.86), odds of ≥ 20 physician visits declined by 47 % (OR 0.53, 95 % CI 0.45-0.63) and the odds of SRH improvement increased by 49 % (OR 1.49, 95 % CI 1.17-1.88) for respondents with high versus low health mastery. Cumulative lifetime adversity manifested a dose-dependent positive relationship with HCU. Specifically, hospitalization odds was, respectively, 25, 80 and 142 % elevated for participants that reported 1-2, 3-4 and 5+ versus 0 lifetime adversities. High versus low global, financial and health mastery, respectively, predicted improved SRH, lower physician's visits and hospitalizations.<bold>Conclusion: </bold>In this sample of adults near or in retirement, resilience predicted lower HCU and improved SRH. Resilience is a dynamic state that can be enhanced in adults with positive impacts on subjective well-being and HCU.
- Subjects
HEALTH outcome assessment; HISTORY of public health; RETIREMENT; SELF-evaluation; REPRESENTATIVE samples; TWENTIETH century
- Publication
Quality of Life Research, 2016, Vol 25, Issue 4, p1007
- ISSN
0962-9343
- Publication type
journal article
- DOI
10.1007/s11136-015-1144-y