J Clin Epidemiol. 2002 Jan; 55(1): 60-6.

The influence of perceived well-being and reported symptoms on health care utilization: a population-based study.

Al-Windi A, Dag E, Kurt S.

Uppsala University, Department of Public Health and Caring Sciences, Family Medicine Section, Uppsala Science Park, 751 85, Uppsala, Sweden. [email protected]

The aim of this study was to evaluate the influence of reported well-being and symptoms on the utilization of health care, including alternative medicine. A random, age-stratified sample was drawn from the general population of HÃ¥bo, a municipality in mid-Sweden. Of the 1312 subjects sampled, 827 responded to a postal questionnaire, providing information on health care utilization during the previous year, on a number of well-being variables and on perceived symptoms during the past 3 months. Subjects who reported low scores for perceived health and sleep had significantly more appointments with a physician than subjects reporting high scores. These results remained when the influence of age, sex, marital status, household size, educational level, occupational status and presence of chronic disease, shown to affect health care utilization in a previous report, was taken into account. In addition, multi-symptom reporters had higher odds for appointments with physicians or providers of alternative medicine than those with few symptoms when account was taken of potential confounders. The effect of perceived health was independent of symptom reporting on health care utilization, indicating that there is probably no simple chain of causation involved. Health care consumption, especially out-patient care, appears to be linked to perceived bad health and the multi-symptom reporting, factors that together with other known predictors perhaps might be used to estimate future health care needs.