Health care utilization by people with multiple sclerosis in The Netherlands: results of two separate studies

Purpose : For chronically ill persons it is assumed that they make heavy de mands on health care services. In the literature one hardly finds any publi cations to substantiate or refute this assumption. The main purpose of our study is to describe the health care utilization of people with multiple sc lerosis (MS) in the Netherlands and its relationships with severity and dur ation of the disease. Methods : Two different samples of persons with MS were used. In the first sample (University Hospital Groningen) severity of MS was based on medical judgement, while in the second sample (Dutch Multiple Sclerosis Society) se verity was self-reported. In both samples, use of health care facilities wa s assessed with a mail questionnaire. Results : The methods for determining severity resulted in different distri butions for severity of MS. However, the results were quite similar with re spect to health care utilization. It appeared that the severity of MS was r elated to the number of professional caretakers MS-patients had contact wit h during one year. Duration of MS seemed not to be related to the number of caretakers. Only for specific caretakers, most notably GP, physiotherapist , home help and ergotherapist, the contact frequency increased with severit y of MS. No such relationship was found between the frequency of contact wi th the neurologist and severity of MS. Conclusions : People with MS do not make a heavy demand on health care faci lities in general but only on certain health care provisions. This is in co ntrast with the general notion that all chronically ill make a heavy demand on health care facilities in general.