Determinants of costs of care for patients attending primary care

Abstract

<p>Aims: We aimed to evaluate determinants of costs of somatic and psychiatric care for</p><p>patients attending primary care (PrC).</p><p>Methods: 495 PrC patients filled in a questionnaire including questions on background,</p><p>health behaviour, social contacts, perceived health and depressive symptoms. Costs of</p><p>somatic and psychiatric care were obtained from the local healthcare register.</p><p>Results: During 5 years’ follow-up, total inflation-adjusted costs of care were 8145 Euros</p><p>per capita in 2010 prices: 87.2% was due to somatic and 12.8% to psychiatric care. Age</p><p>associated positively, but being single and working associated negatively with costs</p><p>of somatic care. Costs of psychiatric care were high in young adults, single,</p><p>divorced, unemployed, smokers, and those with few social contacts. In zero-inflated</p><p>multivariate modelling, poor perceived health and being retired increased probability</p><p>of seeking somatic care. Depressive symptoms and being unemployed increased, and old</p><p>age decreased probability of seeking psychiatric care.</p><p>Concerning both services together, poor perceived health and being retired associated</p><p>with increased, but depressive symptoms with decreased likelihood of being a service</p><p>user. Among service users, age group 25-44 and having poor perceived health associated</p><p>with higher costs of care. Female gender, being single, employed, having low education</p><p>level, regular user of alcohol and regular physical exercise associated with lower</p><p>costs of care.</p><p>Conclusions: In patients attending PrC, more than a tenth of total costs of care were</p><p>due to psychiatric care. Patients’ perceived health associated with costs of somatic,</p><p>and depressive symptoms with costs of psychiatric care. Sociodemographic background</p><p>also associated with costs of care.</p>