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Driving factors for the utilisation of healthcare services by people with osteoarthritis in Portugal: results from a nationwide population-based study

2021Journal article Open access
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dc.contributor.authorCosta, D
dc.contributor.authorRodrigues, AM
dc.contributor.authorCruz, EB
dc.contributor.authorCanhão, H
dc.contributor.authorBranco, J
dc.contributor.authorNunes, C
dc.date.accessioned2023-08-27T16:57:32Z
dc.date.available2023-08-27T16:57:32Z
dc.date.issued2021
dc.description.abstractBackground: Worldwide, the current management of knee osteoarthritis appears heterogeneous, high-cost and often not based on current best evidence. The absence of epidemiological data regarding the utilisation of healthcare services may conceal the need for improvements in the management of osteoarthritis. The aim of this study is to explore the profiles of healthcare services utilisation by people with knee osteoarthritis, and to analyse their determinants, according to Andersen's behavioural model. Methods: We analysed a sample of 978 participants diagnosed with knee osteoarthritis from the population-based study EpiReumaPt, in Portugal. Data was collected with a structured interview, and the diagnosis of knee osteoarthritis was validated by a rheumatologist team. With the Two-step Cluster procedure, we primarily identified different profiles of healthcare utilisation according to the services most used by patients with knee osteoarthritis. Secondly, we analysed the determinants of each profile, using multinomial logistic regression, according to the predisposing characteristics, enabling factors and need variables. Results: In our sample, a high proportion of participants are overweight or obese (82,6%, n = 748) and physically inactive (20,6%, n = 201) and a small proportion had physiotherapy management (14,4%, n = 141). We identified three profiles of healthcare utilisation: "HighUsers"; "GPUsers"; "LowUsers". "HighUsers" represents more than 35% of the sample, and are also the participants with higher utilisation of medical appointments. "GPUsers" represent the participants with higher utilisation of general practitioner appointments. Within these profiles, age and geographic location - indicated as predisposing characteristics; employment status and healthcare insurance - as enabling factors; number of comorbidities, physical function, health-related quality of life, anxiety and physical exercise - as need variables, showed associations (p < 0,05) with the higher utilisation of healthcare services profiles. Conclusions: Healthcare utilisation by people with knee osteoarthritis is not driven only by clinical needs. The predisposing characteristics and enabling factors associated with healthcare utilisation reveal inequities in the access to healthcare and variability in the management of people with knee osteoarthritis. Research and implementation of whole-system strategies to improve equity in the access and quality of care are paramount in order to diminish the impact of osteoarthritis at individual-, societal- and economic-level.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationBMC Health Serv Res . 2021 Sep 28;21(1):1022.pt_PT
dc.identifier.doi10.1186/s12913-021-07045-4pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.26/46201
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectOsteoartrite do Joelhppt_PT
dc.subjectQualidade de Vidapt_PT
dc.subjectOsteoarthritis, Kneept_PT
dc.subjectQuality of Lifept_PT
dc.titleDriving factors for the utilisation of healthcare services by people with osteoarthritis in Portugal: results from a nationwide population-based studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1pt_PT
oaire.citation.titleBMC Health Services Researchpt_PT
oaire.citation.volume21pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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