PREDICTORS OF HEALTH-CARE UTILIZATION IN PATIENTS WITH INFLAMMATORY BOWEL-DISEASE - A LONGITUDINAL-STUDY

Objectives To predict health care utilization in patients with inflamm atory bowel disease (IBD), Methods The health care utilization of 222 consecutive IBD patients was studied twice over the course of one year . Utilization consisted of medical care, including visits to the gastr oenterologist and the general practitioner, and non-medical care, incl uding use of a psychotherapist, a dietitian or home care nurse in the last six months. Prior and concurrent socio-demographic, disease-relat ed and psychosocial factors were measured and their association with p atient health care utilization was determined. Results Poor quality of life, disease burden experienced and depression were significantly (P < 0.01) associated with more visits to both gastroenterologist and GP , Disease activity was found to be significantly correlated to gastroe nterologist visits, while female gender was associated with GP visits, Other socio-demographic and disease-related factors were not related to medical care utilization. Results of regression analysis indicated that prior disease burden experienced, social functioning and female s ex are the best predictors of physician visits a year later. Of the co ncurrent factors, the best predictors were disease activity, emotional and social functioning, and disease burden experienced. Psychotherapy and home care were significantly correlated (P < 0.01) with co-morbid ity, disease activity, quality of life and depression. Non-medical car e utilization was not related to the majority of sociodemographic fact ors. Conclusion Psychosocial factors, such as poor quality of life and disease burden experienced, are important predictors of health care u tilization in IBD patients. Addressing these problems should not only increase the patient's quality of life, but also minimize health care utilization. Eur J Gastroenterol Hepatol 10:783-789 (C) 1998 Lippincot t Williams & Wilkins.