Previous consultation and self reported health status as predictors of future demand for primary care

Abstract

Study objective: There has been little prospective investigation of what predicts general practice consultation. The objective of this study was to investigate the extent to which previous primary care consultation and self reported health status are predictors of future primary care consultation. Design: Population based cohort study in two phases. Firstly, a baseline survey (1995/96) to identify the cohort and to obtain self reported health status using the UK census limiting long term illness (LLI) question and the Short Form-36 (SF-36) health profile. Secondly, analysis of general practice medical records for two years (1994/1995) before the survey and for two years (1997/1998) after the survey. Analysis was performed on: (a) all contacts coded by the GP, (b) the subgroup of contacts given a diagnostic morbidity code by the GP. Setting: One general practice in North Staffordshire, UK. Participants: 738 survey respondents who had consented to viewing of medical records including all those who reported LLI together with an age-gender matched control group of those who reported no LLI. Main results: High frequency consulters in 1994/95 were more likely than non-consulters or average consulters in that year to be high consulters in 1997/98 (odds ratio 5.6, 95% confidence interval 3.82 to 8.25, for all contacts; 4.4 for diagnostic coded consultations). Self reported role disability and physical limitation from the SF-36 at baseline increased the probability of being a future high consulter but the effects were weaker than for previous consultation. Previous consultation within a diagnostic group was the main predictor for future consultation within that group with weaker but significant prediction by self reported health status. Conclusions: Reliable morbidity coding in general practice provides the best available basis for predicting future demand in primary care. Self reported health status survey instruments add to this information but on their own are weaker predictors of future consultation.

Socio-Demographic Characteristics and Health Perceptions among Male and Female Visitors to CAM Practitioners in a Total Population Study

“…Some research shows that CAM users, in line with patients of primary care services more generally [5], are more likely to have poorer self-reported health [1,6]. Other studies have shown that the opposite is true, CAM users tend to have better self-reported health [7,8], or that self-reported health has no influence upon CAM use [9].…”

La calidad de vida relacionada con la salud como factor explicativo de la utilización de la consulta de medicina de familia: un estudio bajo el modelo conductual

“…Fuera de sistemas nacionales de salud, la CVRS ha mostrado, junto a la morbilidad, su capacidad para predecir el consumo de recursos en AP 20 . Dentro de sistemas públicos, una peor percepción de la CVRS se ha mostrado como predictora de un mayor uso de la consulta del médico de familia en determinadas patologías crónicas como la osteomuscular 21 , o la obesidad 22 , pero por sí sola, solo es una débil predictora del sobreuso de recursos 23 .…”

Influenza vaccination, pneumococcal vaccination and risk of acute myocardial infarction: matched case-control study

“…To reduce confounding from "healthy user," "indication" or "treatment" biases, we adjusted for many known confounders, including vaccination target groups and cardiovascular risk groups, treatments and general practitioner consultation rate, of which the latter is thought to be related to functional and economic status. 27 Potential confounders such as functional status were not fully accounted for because of unavailability of data, and we did not have data for other triggers, such as stressful life events. Although we observed missing values for variables such as smoking status, systolic blood pressure, BMI and total cholesterol, we used standard imputation procedures to account for these and obtained results similar to those of our complete case analysis.…”