Living with a partner and health care use – results from the MONICA survey Augsburg in Southern Germany

OBJECTIVE Several studies have shown that social relationships are associated with health care use. This study aims to test if and to which extent a proximal element of social relationships, particularly living together with a partner, influences the health care utilisation in the same way as a distal element such as group membership. METHODS On the basis of a representative random sample of a southern German population (4856 participants), the associations were assessed between the following groups of variables: number of consultations with the general practitioner or internists, type of social relationships (living with a partner, friends, relatives, group memberships), need (evaluated and perceived health status), socio-demographic variables. RESULTS All analyses showed associations between living with a partner and health care utilisation. Individuals living with a partner had lower levels of utilisation than individuals not living with a partner (mean: 4.3 vs. 5.2). These associations persisted after controlling for socio-demographic and need variables. For the other indicators of social relationships, though, there were no significant associations with outpatient visits. CONCLUSIONS Distinguishing between different types of social relationships is important for disentangling the overall effects of social relationships on health care utilisation. Also, the empirical findings confirm that health care research should not be restricted to medical variables, but should also include psycho-social factors.