Abstract
BackgroundTo examine the association between number and combination of chronic disease risk factors on health service use.MethodsData from the 1995 Nova Scotia Health Survey (n = 2,653) was linked to provincial health services administrative databases. Multivariate regression models were developed that included important interactions between risk factors and were stratified by sex and at age 50. Negative-binomial regression models were estimated using generalized estimating equations assuming an autoregressive covariance structure.ResultsAs the number of chronic disease risk factors increased so did the number of annual general practitioner visits, specialist visits and days spent in hospital in people aged 50 and older. This was not seen among individuals under age 50. Comparison of smokers, people with high blood pressure and people with high cholesterol showed no significantly different impact on health service use.ConclusionAs the number of chronic disease risk factors increased so did health service use among individuals over age 50 but risk factor combination had no impact.
Highlights
To examine the association between number and combination of chronic disease risk factors on health service use
Participants from the 1995 Nova Scotia Health Survey (NSHS) with information on risk factors were linked to provincial health services utilization data and followed prospectively for six years
Large variations in risk factor status and health service utilization were seen between men and women as well as between the young and old Regression Models Models were constructed for each outcome: number of annual GP visits, number of annual specialist visits, and number of annual hospital bed-days
Summary
To examine the association between number and combination of chronic disease risk factors on health service use. Cardiovascular disease is not the only concern: other chronic diseases such as cancer, pulmonary diseases, diabetes and osteoporosis are likely to increase in number [5,6] Risk factors such as smoking, high blood pressure, cholesterol, obesity, physical inactivity and diabetes are common to many of these chronic diseases. Quantifying the impact of chronic disease risk factors on health care use can be used to estimate the return on investment of health promotion and other policies designed to prevent chronic disease. It provides a powerful means of communicating the value of risk factor modification to the public and policy makers.
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