PSYCHOLOGICAL DISTRESS AND USE OF AMBULATORY MEDICAL-SERVICES IN THE QUEBEC MEDICARE SYSTEM

Objective. To document the impact of psychological distress symptoms o n the use of ambulatory medical services in a universal insurance cove rage context. Data Sources. Data from the Quebec Health Survey (1987) linked with billing data from the Quebec Medicare system. The time fra me for the utilization variables is one year before and one year after the QHS survey. Study Design. LISREL was used to test a model introdu cing perceived health need as an explanatory factor of the relationshi p between psychological distress and the number of visits to a physici an. Two samples were formed from the matched file. Sample A (n = 2,000 ) was used in an exploratory phase to adequately specify the model. Sa mple B (n 2,000) was used to confirm the results obtained with Sample A. Principal Findings. The proposed model explained 35 percent of the number of visits to a physician in Sample A and 24 percent in Sample B . The effect of psychological distress symptoms on the respondent's pe rceived health need was as important as the effect of physical health status. The effect of the respondent's previous health services utiliz ation on the number of visits to a physician was also significant. Con clusions. These results may be interpreted to indicate that in a unive rsal insurance coverage context, psychological distress is a significa nt predictor of perceived health need.