Healthcare utilisation and health literacy among young adults seeking care in Sweden: findings from a cross-sectional and retrospective study with questionnaire and registry-based data

Abstract

Aim: The objective of this study was to examine young adults’ healthcare utilisation and its possible association with health literacy. Background: Many countries struggle with insufficient accessibility at emergency departments (EDs) and primary healthcare centres (PHCs). Young adults, aged 20–29 years old, account for a substantial number of unnecessary doctor visits where health literacy could be an explanatory factor. Method: This study incorporated a combined retrospective and cross-sectional study design with analysis of registry data, including all registered outpatient doctor visits between 2004 and 2014 (n = 1 086 432), and strategic sample questionnaire data (n = 207), focusing on socio-demographics, symptoms and information-seeking behaviour. Mean differences between first-year and last-year doctor visits for each age group were calculated using registry data. Fischer’s exact test was applied to questionnaire data to analyse group differences between ED and PHC visitors as well as between patients with sufficient health literacy and insufficient health literacy. Binary logistic regression was used to investigate covariation. Findings: Healthcare utilisation has increased among young adults during the past decade, however, not comparatively more than for other age groups. ED patients (n = 49) compared to PHC patients (n = 158) were more likely to seek treatment for gastrointestinal symptoms (P = 0.001), had shorter duration of symptoms (P = 0.001) and sought care more often on the recommendation of a healthcare professional (P = 0.001). Insufficient/problematic health literacy among young adults was associated with having lower reliance on the healthcare system (P = 0.03) and with a greater likelihood of seeking treatment for psychiatric symptoms (P = 0.002). Conclusion: Young adults do not account for the increase in healthcare utilisation during the last decade to a greater extent than other age groups. Young adults’ reliance on the healthcare system is associated with health literacy, an indicator potentially important for consideration when studying health literacy and its relationship to more effective use of healthcare services.

Young adults’ needs when seeking first-line healthcare: A grounded theory design

“…Health literacy is also a factor when seeking healthcare in regards to approachability (i.e., comprehending information, identifying services, and participating in outreach activities) [ 34 ]. Earlier research has shown that patients with insufficient health literacy have lower reliance on healthcare systems [ 2 ]. If healthcare wants to change how young adults seek care, it is important to foster trust, reliance, and transparency [ 35 ].…”

“…The period for data collection was April 2017 to June 2018. As participants were recruited from an earlier study [ 2 ], the inclusion criteria followed the requirements of that study: age 20–29 years, speaking and understanding the Swedish language, and seeking care for a minor injury or disease at that particular healthcare visit. Thereafter, theoretical sampling was performed.…”

“…Depending on the data collection method, informants were chosen in various ways. For most of the interviews, participants had been asked in the previous study [ 2 ] about participation and those who agreed were contacted either by telephone or e-mail, after which a time and place were decided on for the interview. The face-to-face interviews took place in an undisturbed room at the research unit in accordance with the wishes of the informants.…”

“…Healthcare outpatient visits have increased in recent years, and long wait times for care have become an issue in many countries [ 1 , 2 ]. Therefore, potentially avoidable healthcare visits have become a topic of research.…”

GIS-based approaches on the accessibility of referral hospital using network analysis and the spatial distribution model of the spreading case of COVID-19 in Jakarta, Indonesia

“…Many literatures have discussed about the significant effect that is being caused by the COVID-19 i.e., the limitations and the needs of improvement on infrastructure and utility [7,12,16], participation of community [6,17], and human movement by tracking and movement modelling [9,10,18]. But, during this pandemic, it is important to have information on how the condition of existing health care capacities, especially Referral Hospital for COVID-19 in Jakarta in contrast to the demand.…”