Title
The pattern of health care utilization of elderly people with arthritic pain in the hip or knee
Author
Hopman-Rock, M.
de Bock, G.H.
Bijlsma, J.W.J.
Springer, M.P.
Hofman, A.
Kraaimaat, F.W.
TNO Preventie en Gezondheid
Publication year
1997
Abstract
Objective: The aim of the study was to determine the pattern of health care utilization of people aged 55-74 years with arthritic pain in the knee or hip. Design: People with current pain were identified in a population- based study. A filter model was used to describe the pattern of health care utilization of people who presented as patients at different levels (GPs or specialist) of the health care system in the Netherlands. Setting: The study was carried out in the district of Ommoord in Rotterdam in an age- and gender-representative sample of 831 (response 83%; n = 691) people. Study participants: A group of 186 people with current pain was identified. They completed a questionnaire and were interviewed. Main outcome measures: Background variables, illness-related variables (including radiological osteoarthritis), and self-reported diagnoses were described and compared for attenders and non-attenders of GPs and specialists. A reference group of patients of GPs was used to determine the validity and generalizability of the findings. Results: Eighty-two per cent consulted a GP (passed filter 1). In 69% of the GP attenders, 'arthritis' was identified (passed filter 2), and 65% of them attended a specialist (passed filter 3). People who did not pass the various filters were different from those who did with respect to the body mass index (lower; OR 1.24), the chronicity of pain (less chronic pain; OR 4.9) and attendance of a physiotherapist (lower; OR 5.6). The chronicity of pain seems of more importance in determining the health care utilization pattern than the severity of pain, the level of disability or the presence of radiological osteoarthritis. We suggest that health promotion interventions could increase the self-management ability of patients and could lower costs.
Subject
Health
Aged
Health care
Osteoarthritis
Pain
Analysis of Variance
Case-Control Studies
Female
Health Behavior
Health Services
Hip Joint
Humans
Knee Joint
Logistic Models
Male
Middle Aged
Netherlands
Odds Ratio
Osteoarthritis
Physician's Practice Patterns
Prevalence
Referral and Consultation
Utilization Review
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DOI
https://doi.org/10.1093/intqhc/9.2.129
TNO identifier
233955
ISSN
1353-4505
Source
International Journal for Quality in Health Care, 9 (2), 129-137
Document type
article