1 Department of Global Public Health and Primary Care, University of Bergen, Norway.
2 Centre of Health Research, Førde Hospital Trust, Norway.
Scand J Public Health. 2019 Feb;47(1):37-44. doi: 10.1177/1403494818772212. Epub 2018 Apr 29.
Self-rated health (SRH) is a predictor of future health. However, the association between SRH in adolescence and health problems and health care utilization in adulthood has rarely been investigated. The aim of this study was to examine adolescent SRH as a predictor of general practitioner consultations in adulthood.
SRH was registered in the Young-HUNT1 survey in 1995-1997 ( N=8828, mean age 16 years, 88% participation rate). General practitioner consultations during 2006-2014 were obtained from a national claims database. The predictive value of adolescent SRH on general practitioner consultations in adulthood was analysed by regression models estimating the relative risks (RR) for the total number of consultations and consultations for psychological, gastrointestinal, musculoskeletal or respiratory problems. Age, sex and baseline measures of chronic disease and health care attendance were used as the adjusting variables.
SRH was reported as 'very good' by 28.4%, 'good' by 60.6% and 'not good' by 11.0% of the respondents. The increases in consultation rates were 21% (RR 1.21, 95% CI 1.15-1.27) and 52% (RR 1.52, 95% CI 1.40-1.64) when comparing respondents with 'very good' SRH to those with 'good' and 'not good' SRH, respectively. We also demonstrated a dose-response association between adolescent SRH and general practitioner consultations for psychological, gastrointestinal, musculoskeletal or respiratory problems.
SRH in adolescence is a predictor for general practitioner consultations in adult life. Previous research shows that SRH is influenced by factors such as well-being, health behaviour, functional status and body satisfaction. Intervention studies are needed to evaluate whether population-based and clinical interventions can improve SRH by improving these factors among adolescents.
自评健康（SRH）是未来健康的预测指标。然而，青春期的 SRH 与成年后健康问题和卫生保健利用之间的关联很少被研究。本研究旨在探讨青春期的 SRH 是否可预测成年后的全科医生就诊。
SRH 在 1995-1997 年的 Young-HUNT1 调查中进行登记（N=8828，平均年龄 16 岁，参与率 88%）。2006-2014 年的全科医生就诊情况从国家索赔数据库中获得。通过回归模型分析青春期 SRH 对成年后全科医生就诊的预测价值，该模型估计总就诊次数和心理、胃肠道、肌肉骨骼或呼吸系统问题就诊次数的相对风险（RR）。年龄、性别以及慢性病和卫生保健就诊的基线测量值被用作调整变量。
有 28.4%、60.6%和 11.0%的受访者报告自评健康“非常好”、“好”和“不好”。与自评健康“好”和“不好”的受访者相比，自评健康“非常好”的受访者就诊率分别增加 21%（RR 1.21，95%CI 1.15-1.27）和 52%（RR 1.52，95%CI 1.40-1.64）。我们还证明了青春期自评健康与心理、胃肠道、肌肉骨骼或呼吸系统问题的全科医生就诊之间存在剂量反应关系。
青春期的 SRH 是成年后全科医生就诊的预测指标。既往研究表明，SRH 受幸福感、健康行为、功能状态和身体满意度等因素的影响。需要开展干预研究，以评估基于人群和临床的干预措施是否可以通过改善青少年的这些因素来提高 SRH。
