Determinanten van medische consumptie bij oudere ziekenfondsverzekerden

Investigating to what extent the medical consumption of persons aged 50-80 yr covered by the Dutch National Health Service is explaine by their health condition and sociodemographic factors like age, gender, marital status and education.

Design

Questionnaire.

Setting

15 general practices (3 in each of 5 municipalities) in the provinces Drenthe and Overijssel, the Netherlands.

Method

A one-time prestructured health questionnaire (in writing) was sent to 1875 persons aged 50-80 yr covered by the Dutch National Health Service (125 randomly selected persons from each practice). The response was 55 (n = 1022). The objective and subjective health conditions and the sociodemographic factors were tested in relation to the medical consumption (visiting a general practitioner, a specialist, or hospitalization) with a type of regression analysis with which both direct and indirect relations with medical consumption could be calculated.

Results

The medical consumption was explained for 17 by the health condition, the age and the level of education of patients. Elderly, single women with little education had the highest medical consumption. This was mainly determined by the higher probability of health problems in this group. Apart from this there was an age-related increase in medical consumption.

Conclusion

Only part of the medical consumption can be explained by the main literature determinants of medical consumption. Refinement in research can be achieved by relating the care demand to research into referral behaviour of general practitioners and specialists, which can result in supplementary knowledge on determinants of medical consumption.