Health-care utilization in Dutch systemic sclerosis patients

• Published in: Clinical rheumatology 2014-06, Vol.33 (6), p.825-832
• Main Authors: Meijs, Jessica, Zirkzee, Elisabeth J. M., Schouffoer, Anne A., Henquet, Stella M., Caljouw, Monique A. A., Stijnen, Theo, Huizinga, Tom W. J., Schuerwegh, Annemie J. M., Vliet Vlieland, Theodora P. M.
• Format: Article
• Language: English
• Subjects: Cross-Sectional Studies; Delivery of Health Care - utilization; Health Care Surveys; Humans; Medicine; Medicine & Public Health; Multivariate Analysis; Netherlands; Original Article; Quality of Life; Regression Analysis; Reproducibility of Results; Rheumatology; Rheumatology - methods; Scleroderma, Systemic - therapy; Social Class; Surveys and Questionnaires
• ISSN: 0770-3198; 1434-9949
• DOI: 10.1007/s10067-013-2373-5

This study aims to examine healthcare utilization and its determinants among patients with systemic sclerosis (SSc). A cross-sectional survey among all patients with SSc visiting an outpatient clinic of an academic hospital in the Netherlands was done. Assessments included sociodemographic characteristics and a survey on healthcare utilization including a registration of contacts with healthcare services since onset of disease, contacts, and number of visits with healthcare services over the last 12 months. A total healthcare utilization score of all visits over the last 12 months was computed and classified as high and low care utilization according to the median. In addition, the Short Form-36 and the Scleroderma Health Assessment Questionnaire (SHAQ) were administered. Logistic regression analysis was used to determine the relationship between high and low healthcare utilization as dependent variable and sociodemographic and disease characteristics as independent variables. Sixty-four patients returned the questionnaires. Over the last 12 months, 83 % of the patients had had contact with one or more physicians. On average, patients reported 3.9 visits (SD, 2.9) to a rheumatologist and 6.9 visits (SD, 9.3) to other medical specialists over the last 12 months. The median total health-care utilization was six visits over the last 12 months. Multivariate regression showed that a higher SHAQ score was significantly associated with higher health-care utilization. Patients with SSc visited a considerable number of various health-care providers. Patients with more functional disability were using more healthcare.