Major and minor life events as predictors of medical utilization

Abstract

Research suggests stressful life events can negatively influence physical and mental health in a number of ways. While previous research indicates both major and minor life events contribute unique variance to the prediction of physical and mental symptoms, little research has examined the relationships of both major and minor life events with medical utilization. The current study included a predominantly African American, low-income sample of adults (N = 207) attending two primary care outpatient clinics and assessed their experience of both major and minor life events over the course of one year. Medical utilization data were collected over a subsequent four-year period and included total utilization, outpatient visits, emergency department visits, and hospitalizations. Hierarchical multiple regressions were used to determine if the frequency and perceived impact of major and minor stressful events predicted subsequent medical utilization in this sample of primary care patients. After controlling for age, gender, ethnicity, and number of chronic illnesses, none of the stress measures showed a significant relationship to any type of utilization in the sample as a whole. When examining only patients from the family practice clinic who had access to a regular primary care physician (N = 141), the perceived impact of minor life events made unique contributions in predicting total medical utilization and outpatient visits, such that higher perceived impact was associated with higher rates of medical services use. The frequency of minor life events was also a significant predictor of outpatient visits, with more frequent minor life events associated with greater utilization. Neither the frequency nor impact of major life events was predictive of utilization. Results indicate minor life events may influence medical utilization for some patients, although access to medical care appears to be an important variable affecting this relationship.