Determinants of costs of care for patients attending primary care

Luutonen Sinikka

Hietala Jarmo

Salokangas Raimo

Salokangas Henri

From Tiina

Lataukset:

Psykiatrian Tutkimussäätiö

Aims: We aimed to evaluate determinants of costs of somatic and psychiatric care for

patients attending primary care (PrC).

Methods: 495 PrC patients filled in a questionnaire including questions on background,

health behaviour, social contacts, perceived health and depressive symptoms. Costs of

somatic and psychiatric care were obtained from the local healthcare register.

Results: During 5 years’ follow-up, total inflation-adjusted costs of care were 8145 Euros

per capita in 2010 prices: 87.2% was due to somatic and 12.8% to psychiatric care. Age

associated positively, but being single and working associated negatively with costs

of somatic care. Costs of psychiatric care were high in young adults, single,

divorced, unemployed, smokers, and those with few social contacts. In zero-inflated

multivariate modelling, poor perceived health and being retired increased probability

of seeking somatic care. Depressive symptoms and being unemployed increased, and old

age decreased probability of seeking psychiatric care.

Concerning both services together, poor perceived health and being retired associated

with increased, but depressive symptoms with decreased likelihood of being a service

user. Among service users, age group 25-44 and having poor perceived health associated

with higher costs of care. Female gender, being single, employed, having low education

level, regular user of alcohol and regular physical exercise associated with lower

costs of care.

Conclusions: In patients attending PrC, more than a tenth of total costs of care were

due to psychiatric care. Patients’ perceived health associated with costs of somatic,

and depressive symptoms with costs of psychiatric care. Sociodemographic background

also associated with costs of care.