Socioeconomic determinants of rates of consultation in general practice based on fourth national morbidity survey of general practices

Carr‐Hill, Roy; Rice, Nigel; Roland, Martin

doi:10.1136/bmj.312.7037.1008

Cited by 185 publications

(129 citation statements)

References 19 publications

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“…Similar results were obtained in a study on the clientele of general practitioners in the UK National Health System, where individuals born in India, Pakistan, and Bangladesh visited physicians more frequently, probably reflecting greater need 23 .…”

Section: Medical Consultationssupporting

confidence: 72%

Health inequalities based on ethnicity in individuals aged 15 to 64, Brazil, 1998

Barata¹,

Almeida

Montero

et al. 2007

Cad. Saúde Pública

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This study aimed to analyze inequalities in health status and utilization of medical consultations and hospital services by IntroductionEquity in health may be defined as the absence of unfair inequalities, or for operational purposes, as the absence of systematic inequalities between groups with different social positions due to different levels of wealth, power, and prestige 1 .The concept of equity is inherently normative, whereas inequality may denote only a difference, without any connotation of injustice. The central idea in the concept of equity can be expressed as equal opportunities to be and remain healthy and is rooted in the right to health. It also includes the right to decent living standards, as well as other human rights, such freedom from discrimination and the ability to fully participate in community life (social inclusion). Health inequality is unfair if it is systematically associated with social disadvantages in such a way that the social groups that are already penalized because of their socioeconomic status suffer further disadvantages in the promotion, protection, and recovery of their health 1 .The usual explanation for health inequalities has been that one's lifestyle is the expression of individual choices and behaviors that can either reinforce or jeopardize health. However, the control of such variables cannot suppress some differentials 2 . Health inequalities always reflect social determinants, there is usually no specificity between particular causes and outcomes, ARTIGO ARTICLE

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Section: Medical Consultationssupporting

confidence: 72%

Health inequalities based on ethnicity in individuals aged 15 to 64, Brazil, 1998

Barata¹,

Almeida

Montero

et al. 2007

Cad. Saúde Pública

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“…The rates of hospital outpatient visits influence the hospitalisation rates (7). Increasing distance to hospital has been found to reduce rates of both hospitalisations and hospital outpatient visits (14,15) as was found in our study, although in the stepwise regression analysis distance did not fall out. People living close to their GPs make more visits than those living some distance further away.…”

Section: Discussioncontrasting

confidence: 38%

Determinants of hospitalisation rates: does primary health care play a role?

Lindström¹,

Engström²,

Bengtsson

et al. 2003

Scandinavian Journal of Primary Health Care

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“…Si introducimos las variables por bloques, la CVRS (EuroQol-5D, utilidades) explica un 5,2% de la variabilidad, vivir en barrios de rentas altas un 13 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) IC 95%: Intervalo de confianza del 95%; Rango IC: rango intercuartílico (percentil 25-percentil 75); EuroQol 5D: Cuestionario EuroQol 5D que consta de Escala Visual Analógica (EVA) y Utilidades 2,4%, la edad añade un 7,4% de la capacidad explicativa, la renta individual un 1,0% y los factores relacionados con la «necesidad» (enfermedades crónicas e ingresos hospitalarios) explican un 4,1% adicional de la variabilidad.…”

Section: Resultsunclassified

“…En estos, cuando no existe un pago directo a la hora de acceder al servicio, parece haber más uso cuanto menor es la renta para los servicios en atención primaria (una «inequidad pro-pobres») 10,11 , y una relación menos definida en otros niveles asistenciales 12 . En estos entornos la accesibilidad al servicio, puede ser el limitante del uso 13,14 .…”

Section: Introductionunclassified

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

Fernández

Gómez-Gascón

Cura-González

et al. 2010

Rev. Esp. Salud Publica

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RESUMENFundamento: La utilización de servicios sanitarios se ha estudiado desde varios modelos conceptuales. El objetivo de este trabajo es valorar la influencia de la calidad de vida relacionada con la salud (CVRS) en la variabilidad de la utilización de la consulta de atención primaria bajo el «modelo conductual».Métodos: Estudio transversal analítico. Se entrevistó a 451 sujetos de 6 centros de salud en la Comunidad de Madrid. Se recogieron característi-cas relacionadas con factores ambientales e individuales (predisponentes, facilitadores y de necesidad) y la CVRS (Euroqol-5D). La utilización se recogió de la historia clínica informatizada.Resultados: Hubo una mediana de 13 visitas/año (rango intercuartil 7-20). La CVRS explicaba un 5,2% de la variabilidad en la utilización, vivir en barrios de rentas altas un 2,4%, la edad un 7,4%, la renta individual un 1,0% y los factores relacionados con «necesidad» (enfermedades cró-nicas e ingresos hospitalarios) explicaban un 4,1% de variabilidad adicional. Cada cambio de tercil de la CVRS se asoció con una disminución del 13,8% en las consultas/año. La residencia en zonas de renta alta y cada aumento de 1000 de renta individual disminuían la utilización un 17,5% y un 9,5% respectivamente. La edad se asociaba con un aumento de un 8,0% de visitas/año por década. El sufrir enfermedades crónicas o ingresos hospitalarios suponía aumentar un 51,9% y un 26,5% las visitas anuales.Conclusiones: La CVRS se asocia de manera independiente con la variabilidad en la utilización de la consulta del médico de familia, una vez ajustado el efecto de la necesidad, como propone el «modelo conductual». ABSTRACT Quality of Life Related to Health as a Factor Explaining the Use of Family Medical Consultation: A Study on the Behavioral ModelBackground: Health services utilization has been studied under several conceptual models. This study is aimed to assess the influence of Health Related Quality of Life (HRQL) on the variability of the primary care consultation utilization under the «behavioral model» Methods: A cross-sectional study. Interviews were conducted with 451 subjects at six health centers in the Community of Madrid. Environmental and individual characteristics (predisposing, enabling and need factors) and HRQL (EuroQol-5D) were collected. Annual visits were retrieved from the computerized clinical history.Results: Median utilization was 13 visits/year (interquartile range 7-20). HRQL explained 5,2% of utilization variability, living in high-income areas an additional 2.4%, age a 7.4%, incomes a 1.0% and «need factors» (chronic illnesses or a hospital admission in the last year) explained an additional 4.1% of the variability. Each increase of the tercile in the perception of HRQL was associated with a decrease of 13,8% of the number of visits/year. Living in high-income areas, and each increase of 1000 in the incomes decreased the percentage of annual visits 17.5 % and 9.5% respectively. Age is associated with an increase of 8.0% of annual visits per decade. Suffering from chron...

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Socioeconomic determinants of rates of consultation in general practice based on fourth national morbidity survey of general practices

Cited by 185 publications

References 19 publications

Health inequalities based on ethnicity in individuals aged 15 to 64, Brazil, 1998

Health inequalities based on ethnicity in individuals aged 15 to 64, Brazil, 1998

Determinants of hospitalisation rates: does primary health care play a role?

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

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