Claims data analysis of medical specialist utilization among nursing home residents and community-dwelling older people

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 impairment^a
Cardiology	+	–	+	o	Coronary disease, heart disease, hypertension
Ophthalmology	+	o	+	+	Diseases of the eye
Orthopedics	+	–	+	–	Arthropathy, osteopathy and chondropathy, spinal disease
	+		+		Motor impairment^a
	+	o	+	o	Injury
Gynecology	+	o	+	o	Urinary tract disease, disorders of female genital tract
Urology	+	o	+	o	Urinary tract disease
Urology	o	o	+	o	Prostate disease
Surgery	o	o	o	o	Skin disease, injury
Dermatology	+	o	+	o	Bedsore/decubitus
Dermatology	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

ISSN: 1472-6963