Lower decision threshold for doctor visits as a predictor of health care use in somatoform disorders and in the general population

AbstractFew studies have investigated the relationship of temperament and character, as conceptualized in the Temperament and Character Inventory–Revised (TCI-R), to symptoms of depression and anxiety in the general population. In this study a random sample of subjects (20 to 70 years), in two Finnish cities, were surveyed with the TCI-R, Beck Depression and Anxiety Inventories, plus questions related to diagnosed lifetime mental disorders, health care use for psychiatric reasons during the past 12 months, and history of mental disorders in first-degree relatives. Altogether 347 subjects (38.6%) responded. Of the TCI-R dimensions, Harm Avoidance correlated with symptoms of depression (rs = 0.555, p < 0.001), anxiety (rs= 0.560, p < 0.001), self-reported lifetime mental disorder (rs = 0.272, p< 0.001), health care use for psychiatric reason during the past 12 months (rs = 0.241, p< 0.001) and family history of mental disorder (rs = 0.202, p<0.001). Self-directedness correlated negatively with symptoms of depression (rs = -0.495, p< 0.001), anxiety (rs = -0.458, p < 0.001), lifetime mental disorder (rs = 0.225, p< 0.001) and health care use (rs = -0.135, p = 0.013). Overall, Harm Avoidance and Self-directedness seem to associate moderately with depressive and anxiety symptoms, and somewhat predict self-reported use of health services for psychiatric reasons, and lifetime mental disorder. High harm avoidance may associate with a family history of mental disorder.

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Cohort profile: the Comparative Outcomes And Service Utilization Trends (COAST) Study among people living with and without HIV in British Columbia, Canada

BMJ Open ◽

10.1136/bmjopen-2017-019115 ◽

2018 ◽

Vol 8 (1) ◽

pp. e019115 ◽

Cited By ~ 6

Author(s):

Oghenowede Eyawo ◽

Mark W Hull ◽

Kate Salters ◽

Hasina Samji ◽

Angela Cescon ◽

...

Keyword(s):

Health Care ◽

British Columbia ◽

General Population ◽

Health Service ◽

Service Utilization ◽

Service Use ◽

Data Linkage ◽

Health Care Use ◽

Health Service Use ◽

People Living With Hiv

PurposeThe Comparative Outcomes And Service Utilization Trends (COAST) Study in British Columbia (BC), Canada, was designed to evaluate the determinants of health outcomes and health care services use among people living with HIV (PLHIV) as they age in the period following the introduction of combination antiretroviral therapy (cART). The study also assesses how age-associated comorbidities and health care use among PLHIV may differ from those observed in the general population.ParticipantsCOAST was established through a data linkage between two provincial data sources: The BC Centre for Excellence in HIV/AIDS Drug Treatment Program, which centrally manages cART dispensation across BC and contains prospectively collected data on demographic, immunological, virological, cART use and other clinical information for all known PLHIV in BC; and Population Data BC, a provincial data repository that holds individual event-level, longitudinal data for all 4.6 million BC residents. COAST participants include 13 907 HIV-positive adults (≥19 years of age) and a 10% random sample inclusive of 516 340 adults from the general population followed from 1996 to 2013.Findings to dateFor all participants, linked individual-level data include information on demographics, health service use (eg, inpatient care, outpatient care and prescription medication dispensations), mortality, and HIV diagnostic and clinical data. Publications from COAST have demonstrated the significant mortality reductions and dramatic changes in the causes of death among PLHIV from 1996 to 2012, differences in the amount of time spent in a healthy state by HIV status, and high levels of injury and mood disorder diagnosis among PLHIV compared with the general population.Future plansTo capture the dynamic nature of population health parameters, regular data updates and a refresh of the data linkage are planned to occur every 2 years, providing the basis for planned analysis to examine age-associated comorbidities and patterns of health service use over time.

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Mental health care use in medically unexplained and explained physical symptoms: findings from a general population study

Neuropsychiatric Disease and Treatment ◽

10.2147/ndt.s109504 ◽

2016 ◽

Vol Volume 12 ◽

pp. 2063-2072 ◽

Cited By ~ 6

Author(s):

J van Eck van der Sluijs ◽

Margreet ten Have ◽

Cees Rijnders ◽

Harm van Marwijk ◽

Ron de Graaf ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

General Population ◽

Mental Health Care ◽

Population Study ◽

Physical Symptoms ◽

Health Care Use ◽

General Population Study ◽

Medically Unexplained ◽

Mental Health Care Use

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Combined impact of ADHD and insomnia symptoms on quality of life, productivity, and health care use in the general population

Psychological Medicine ◽

10.1017/s0033291720001592 ◽

2020 ◽

pp. 1-12 ◽

Cited By ~ 1

Author(s):

Emma van Andel ◽

Margreet ten Have ◽

Denise Bijlenga ◽

Aartjan T. F. Beekman ◽

Ron de Graaf ◽

...

Keyword(s):

Quality Of Life ◽

Health Care ◽

General Population ◽

Sleep Problems ◽

Productivity Loss ◽

Health Care Use ◽

Mental Functioning ◽

Wide Range ◽

Insomnia Symptoms

Abstract Background Both attention-deficit/hyperactivity disorder (ADHD) and insomnia have been independently related to poorer quality of life (QoL), productivity loss, and increased health care use, although most previous studies did not take the many possible comorbidities into account. Moreover, ADHD and insomnia often co-occur. Symptoms of ADHD and insomnia together may have even stronger negative effects than they do separately. We investigated the combined effects of symptoms of ADHD and insomnia, in addition to their independent effects, on QoL, productivity, and health care use, thereby controlling for a wide range of possible comorbidities and confounders. Methods Data from the third wave of the Netherlands Mental Health Survey and Incidence Study-2 were used, involving N = 4618 from the general population. Both the inattention and the hyperactivity ADHD symptom dimensions were studied, assessed by the ASRS Screener. Results Mental functioning and productivity were negatively associated with the co-occurrence of ADHD and insomnia symptoms, even after adjusting for comorbidity and confounders. The results show no indication of differences between inattention and hyperactivity. Poorer physical functioning and health care use were not directly influenced by the interaction between ADHD and insomnia. Conclusions People with both ADHD and sleep problems have increased risk for poorer mental functioning and productivity loss. These results underscore the importance of screening for sleep problems when ADHD symptoms are present, and vice versa, and to target both disorders during treatment.

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Health Care Use Among Endometrial Cancer Survivors: A Study From PROFILES, a Population-Based Survivorship Registry

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e31829dd1e3 ◽

2013 ◽

Vol 23 (7) ◽

pp. 1258-1265 ◽

Cited By ~ 7

Author(s):

Nicole P.M. Ezendam ◽

Kim A.H. Nicolaije ◽

Dorry Boll ◽

Marnix L.M. Lybeert ◽

Floortje Mols ◽

...

Keyword(s):

Health Care ◽

Endometrial Cancer ◽

General Practitioner ◽

General Population ◽

Cancer Survivors ◽

Health Care Use ◽

Medical Specialist ◽

Younger Women ◽

Highly Educated ◽

Care Services

ObjectiveIncreasing numbers of endometrial cancer survivors place a high burden on the health care system. This study describes the number of visits to the general practitioner, the medical specialist and other care services, compared with the general population, and factors associated with this health care use: age, marital status, education, body mass index, comorbidity, years since diagnosis, and radiotherapy.MethodsSurvivors of stage I to stage II endometrial cancer diagnosed between 1999 and 2007 were selected from the Eindhoven Cancer Registry. Survivors (N = 742) completed a questionnaire about their demographic characteristics and health care use. Cancer-related information was retrieved from the Eindhoven Cancer Registry.ResultsEndometrial cancer survivors visited their medical specialist more often (3.4 times per year) than the general population. In relation to their cancer, they visited their general practitioner once and their medical specialist twice per year. Use of additional care services was low (14%) but higher among younger survivors (33%). Younger women were more likely to make cancer-related visits to their general practitioner, whereas more highly educated women were less likely to visit their general practitioner and more likely to make cancer-related medical specialist visits. Women with more comorbid conditions were more likely to make general and cancer-related general practitioner visits. Radiotherapy and body mass index were not related to health care use.ConclusionsEndometrial cancer survivors use more health care than women in the general population. Younger women visit their general practitioner more often in relation to their cancer and use more additional care services. More highly educated survivors were more likely to visit a medical specialist in relation to their cancer.

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Chronic pain is associated with increased health care use among community-dwelling older adults in Brazil: the Pain in the Elderly (PAINEL) Study

Family Practice ◽

10.1093/fampra/cmy123 ◽

2018 ◽

Vol 36 (5) ◽

pp. 594-599 ◽

Cited By ~ 2

Author(s):

Juliana L Torres ◽

Silvia L A da Silva ◽

Fabiane R Ferreira ◽

Liliane P S Mendes ◽

Luciana A Machado

Keyword(s):

Older Adults ◽

Health Care ◽

Chronic Pain ◽

Pain Intensity ◽

The Elderly ◽

Population Based ◽

Community Dwelling ◽

Health Care Use ◽

Cross Sectional ◽

Doctor Visits

Abstract Background Chronic pain is known to increase health care use in high-income countries, but in Brazil, little is known. Objective To investigate the association between chronic pain and health care use among Brazilian older adults and explore the relationship between pain severity and health care use. Methods This cross-sectional study was derived from the population-based study Frailty in Brazilian Older People-FIBRA. Chronic pain, pain intensity and pain-related disability were assessed through additional telephone interviews. Health care use was measured by the number of doctor visits, hospitalization events and high health care use (highest quartile of the distribution for number of doctor visits) in the last 12 months. Associations were tested in regression analyses adjusted for predisposing, enabling and illness-level components from the Andersen Model. Results The 383 participants were predominantly female (71.0%), mean age was 75.6 (6.1 SD). The prevalence of chronic pain was 30.0%. Chronic pain was associated with number of doctor visits [unstandardized B coefficient 1.48; 95% confidence interval (CI) = 0.35–2.62] and high health care use [odds ratios (OR) = 2.27; 95% CI = 1.39–3.72]. Pain intensity was associated with high health care use in univariate (OR = 1.13; 95% CI = 1.06–1.20) but not multivariate analysis (OR = 1.12; 95% CI = 0.94–1.33). Pain-related disability was not associated with any outcome. Conclusion Chronic pain increased health care use among Brazilian older adults. Improving the quality of primary care management of individuals at greater risk of chronic pain should be a cornerstone of health policies directed towards reducing the personal and societal burden of ageing.

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Patterns of health care use and out-of-pocket payments among general population and social security beneficiaries in Myanmar

BMC Health Services Research ◽

10.1186/s12913-019-4071-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Chaw-Yin Myint ◽

Milena Pavlova ◽

Wim Groot

Keyword(s):

Health Care ◽

General Population ◽

Social Security ◽

Health Care Use ◽

Out Of Pocket Payments ◽

Social Security Beneficiaries

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The Association of Post-Materialism with Health Care Use. Findings of a General Population Survey in Germany

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17238869 ◽

2020 ◽

Vol 17 (23) ◽

pp. 8869

Author(s):

André Hajek ◽

Hans-Helmut König

Keyword(s):

Health Care ◽

Negative Binomial ◽

Outcome Measure ◽

General Social Survey ◽

Total Sample ◽

Chronic Illnesses ◽

Health Care Use ◽

Future Research ◽

Doctor Visits ◽

Underlying Mechanisms

(1) The aim of this study was to identify the association between post-materialism and health care use (in terms of the frequency of doctor visits and the reason for doctor visits). (2) Data were taken from the German General Social Survey (a representative sample of individuals aged 18 years and over, n = 3338). The Inglehart’s post-materialist index was used to quantify post-materialism. The doctor visits (self-reported) in the past three months served as an outcome measure. The reasons for seeing a doctor served as an additional outcome measure (acute illness; chronic illness; feeling unwell; requesting advice; visit to the doctor’s office without consulting the doctor (e.g., need to get a prescription); preventive medical check-up/vaccination). (3) After adjusting for several covariates, negative binomial regressions revealed that compared with materialism, post-materialism was associated with decreased doctor visits (total sample; women). Moreover, the likelihood of visiting the doctor for reasons of chronic illnesses was lower in post-materialistic women, whereas the likelihood of visiting the doctor for reasons of preventive medical check-up/vaccination was higher in post-materialistic women. (4) Study findings identify an unexplored link between post-materialism and doctor visits in women. One may conclude that in the long-term, the increased likelihood of preventive medical check-ups in post-materialistic women will be beneficial in decreasing the need for doctor visits for reasons of chronic illnesses. However, future research is required to elucidate the underlying mechanisms.

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