Lekovic Tamara, Janicijevic Nikoleta, Potezica Milos, Djonovic Nela, Vasiljevic Dragan, Janicijevic Katarina, Tepavcevic Melanija, Knezevic Snezana, Vuckovic Filipovic Jelena, Rastoder Celebic Amela, Vukosavljevic Svetlana, Mirocevic Rotolo Maja, Stajic Dalibor
Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
Department of Hygiene and Ecology, Institute of Public Health Kragujevac, Kragujevac, Serbia.
Front Public Health. 2025 Jul 17;13:1569741. doi: 10.3389/fpubh.2025.1569741. eCollection 2025.
This cross-sectional analytical study explores the predictors of the healthcare utilization in the adult population with cardiovascular diseases.
The research was carried out as part of the fourth Serbian National Health Survey, in the period from October to December 2019, as a descriptive, cross-sectional analytical study and included the population of cardiovascular patients ( = 4,712) aged over 20 years; Descriptive and inferential statistical methods, including percentage-based structure indicators, Chi-square (χ2) tests for categorical variable differences, and prevalence ratio for examining relationships between dependent and independent variables, were used in the data analysis.
The analysis identified several significant contributors to cardiovascular healthcare utilization, emphasizing distinct and overlapping factors that impact various types of healthcare use. The chi-square test had shown that predominantly, each form of healthcare utilization was most prevalent among the 60-69 age group (general practitioner visits: 33.9%, specialist visits: 33.1%, hospitalization: 31.4%, < 0.001). Self-assessment of general health (bad/very bad) and the presence of multiple chronic conditions (multimorbidity) were positively associated with general practitioner (PR = 1.037(1.001-1.075); = 0.044, PR = 1.077(1.039-1.117); < 0.001), specialist visits (PR = 1.381(1.281-1.490); < 0.001, PR = 1.279(1.181-1.385); < 0.001) and hospitalization (PR = 4.346(3.272-5.772); < 0.001, PR = 2.018(1.517-2.685); < 0.001).
Sociodemographic, socioeconomic factors and some aspects of health status have a significant impact on the cardiovascular healthcare, thereby precise recommendations for facilitating appropriate healthcare utilization should be established. A top priority for academics, physicians and public health specialists is to keep emphasizing the significance of sociodemographic determinants in lowering cardiovascular complications, as well as strengthening cardiovascular healthcare.
本横断面分析研究探讨了成年心血管疾病患者医疗服务利用的预测因素。
该研究作为第四次塞尔维亚全国健康调查的一部分，于2019年10月至12月期间开展，是一项描述性横断面分析研究，纳入了年龄超过20岁的心血管疾病患者群体（n = 4712）；数据分析采用了描述性和推断性统计方法，包括基于百分比的结构指标、用于分类变量差异的卡方（χ2）检验以及用于检验因变量和自变量之间关系的患病率比。
分析确定了心血管医疗服务利用的几个重要影响因素，强调了影响各类医疗服务使用的不同且相互重叠的因素。卡方检验表明，主要地，每种医疗服务利用形式在60 - 69岁年龄组中最为普遍（全科医生就诊：33.9%，专科医生就诊：33.1%，住院治疗：31.4%，P < 0.001）。总体健康的自我评估（差/非常差）和多种慢性病（多病共存）的存在与全科医生就诊（PR = 1.037(1.001 - 1.075)；P = 0.044，PR = 1.077(1.039 - 1.117)；P < 0.001）、专科医生就诊（PR = 1.381(1.281 - 1.490)；P < 0.001，PR = 1.279(1.181 - 1.385)；P < 0.001）以及住院治疗（PR = 4.346(3.272 - 5.772)；P < 0.001，PR = 2.018(1.517 - 2.685)；P < 0.001）呈正相关。
社会人口统计学、社会经济因素以及健康状况的某些方面对心血管医疗服务有重大影响，因此应制定促进适当医疗服务利用的精确建议。学者、医生和公共卫生专家的首要任务是持续强调社会人口统计学决定因素在降低心血管并发症以及加强心血管医疗服务方面的重要性。
