Préville M, Potvin L, Boyer R
Gerontology Research Center, Sherbrooke Geriatric University Institute, Québec, Canada.
Health Serv Res. 1998 Jun;33(2 Pt 1):275-86.
To document the impact of psychological distress symptoms on the use of ambulatory medical services in a universal insurance coverage context.
Data from the Quebec Health Survey (1987) linked with billing data from the Quebec Medicare system. The time frame for the utilization variables is one year before and one year after the QHS survey.
LISREL was used to test a model introducing perceived health need as an explanatory factor of the relationship between psychological distress and the number of visits to a physician. Two samples were formed from the matched file. Sample A (n = 2,000) was used in an exploratory phase to adequately specify the model. Sample B (n = 2,000) was used to confirm the results obtained with Sample A.
The proposed model explained 35 percent of the number of visits to a physician in Sample A and 24 percent in Sample B. The effect of psychological distress symptoms on the respondent's perceived health need was as important as the effect of physical health status. The effect of the respondent's previous health services utilization on the number of visits to a physician was also significant.
These results may be interpreted to indicate that in a universal insurance coverage context, psychological distress is a significant predictor of perceived health need.
记录在全民医保背景下心理困扰症状对门诊医疗服务使用情况的影响。
来自魁北克健康调查（1987年）的数据与魁北克医疗保险系统的计费数据相链接。使用变量的时间范围是魁北克健康调查前一年和调查后一年。
使用线性结构关系模型（LISREL）来检验一个模型，该模型引入感知健康需求作为心理困扰与就诊次数之间关系的解释因素。从匹配文件中形成了两个样本。样本A（n = 2000）用于探索阶段以充分确定模型。样本B（n = 2000）用于确认样本A获得的结果。
所提出的模型在样本A中解释了35%的就诊次数，在样本B中解释了24%。心理困扰症状对受访者感知健康需求的影响与身体健康状况的影响同样重要。受访者先前的医疗服务使用情况对就诊次数的影响也很显著。
这些结果可以解释为表明在全民医保背景下，心理困扰是感知健康需求的一个重要预测因素。
