Impact of initial physician contact on later-life health service utilization: a life course perspective

Within the context of life course theory, formative life events are acknowledged to profoundly influence an individual’s long-term health-related behaviors. Despite the theoretical significance of this perspective, there is a notable paucity of empirical research applying it to healthcare facility selection by China’s older adults. This study seeks to examine the impact of the type of physician initially consulted in early life on the preference for healthcare institutions in subsequent years. This study analyzed data from the 2014 Life Course Special Survey and the 2018 National Survey of the China Health and Retirement Longitudinal Study (CHARLS). Participants aged 60 years or over, who had accessed inpatient services in the previous year or outpatient services in the preceding month, were included. A binary logistic regression model was utilized to assess the relationship between the type of initial physician encounter and the subsequent selection of outpatient and inpatient facilities by the older adult cohort. The model was adjusted incrementally for control variables including demographic attributes, insurance coverage, health status, and characteristics of healthcare providers. The study comprised 2,491 cases. After adjusting for control variables, a significant finding emerged: individuals who initially encountered a primary care physician were 1.023 times more likely (OR = 2.023, p < 0.01,95% CI:1.38–3.17) to select a primary care facility for outpatient services in later life compared to those whose initial consultation was with a hospital specialist. However, the type of initial primary care physician encounter did not significantly influence the choice of inpatient care facilities among the older adult population. The results indicate a significant association between initial consultations with primary care physicians and a later preference for primary care facilities for outpatient services among older adults. Conversely, the choice of inpatient service facilities does not appear to be influenced by the type of initial physician encounter.