THE PATTERN OF HEALTH-CARE UTILIZATION OF ELDERLY PEOPLE WITH ARTHRITIC PAIN IN THE HIP OR KNEE

Objective: The aim of the study was to determine the pattern of health care utilization of people aged 55-74 years with arthritic pain in th e knee or hip. Design: People with current pain were identified in a p opulation-based study, A filter model was used to describe the pattern of health care utilization of people who presented as patients at dif ferent levels (GPs or specialist) of the health care system in the Net herlands, Setting: The study was carried out in the district of Ommoor d in Rotterdam in an age- and gender-representative sample of 831 (res ponse 83%; n = 691) people, Study participants: A group of 186 people with current pain was identified. They completed a questionnaire and w ere interviewed. Main outcome measures: Background variables, illness- related variables (including radiological osteoarthritis), and self-re ported diagnoses were described and compared for attenders and nonatte nders of GPs and specialists, A reference group of patients of GPs was used to determine the validity and generalizability of the findings. Results: Eighty-two per cent consulted a GP (passed filter 1), In 69% of the GP attenders, 'arthritis' was identified (passed filter 2), and 65% of them attended a specialist (passed filter 3), People who did n ot pass the various filters were different from those who did with res pect to the body mass index (lower; OR 1.24), the chronicity of pain ( less chronic pain; OR 4.9) and attendance of a physiotherapist (lower; OR 5.6). The chronicity of pain seems of more importance in determini ng the health care utilization pattern than the severity of pain, the level of disability or the presence of radiological osteoarthritis. We suggest that health promotion interventions could increase the self-m anagement ability of patients and could lower costs. (C) 1997 Elsevier Science Ltd.