Determinants of health care and drug utilisation : The causes of health care utilisation study

Abstract: The costs of health care and medicines are a considerable and rapidly increasing part of the gross national product in Sweden. like in many other countries.The purpose of this study was to identify factors that influenced the we of health care and drugs in subjects aged 16 years and above in Håbo, a Swedish municipality. The study population consisted of 827 men and women from a random age-stratified population sample of 1,312 subjects. A postal questionnaire was used to collect information on sociodemographic characteristics. well-being variables. symptoms and chronic disease, and on the use of health care (including alternative medicine), drugs (including herbal medicines) and self-care products.Several sociodemographic characteristics, such as as sex, marital status, household size, educational level and occupational status, were related to many of the well-being variables and symptoms. These sociodemographic characteristic were also independently related to the use of health care. drugs and self-care products.Well-being variables (particularly bad perceived health), a high number of symptom (six or more) and chronic disease were also independently related to the use of health care, drugs and self-care products. Combinations of certain independent variables could explain, or "predict", special patterns of health care and drug use. For example, the likelihood of consulting a physician frequently (three times or more per year] was very high in subjects with a certain profile, viz. high age. female sex, sick leave or disability pension bad perceived health. high number of symptoms and chronic disease. Indeed, 31-92% of appointments to a physician could be attributed to these factors, depending on the model used. The same combination of factors, except high age, explained 21 to 91% of the number of patients using prescribed pharmaceuticals. Between 6% and 85% of the number of days in hospital were attributable to the combination of sick-leave or disability pension and bad perceived health, chronic disease.Using information on the most important variables, i.e. those with the strongest independent relationships to the use of health care and drugs. in the population of a specific district may be of value in estimating the demand for health care resources in that district. and in the allocation of resources. It may also provide a basis for preventive efforts aiming at reducing the needs.