Is change in global self-rated health associated with change in affiliation with a primary care provider? Findings from a longitudinal study from New Zealand

Hypertension Status and Associations with Self-Rated Health and General Practitioner Health Seeking in a Rural Australian Cohort

Hypertension is the most frequently managed condition by Australian general practitioners (GP). Knowledge of hypertension and blood pressure (BP) values may motivate individuals to seek GP management. Our study aims to determine the associations of knowledge of BP values, BP perception, GP health seeking, and self-rated health (SRH) in a rural population. Two-hundred and seventy-eight (278) residents responded to the health survey on socio-demographic profile, medical history, BP knowledge and perception, SRH, and GP visit frequency. Associations were evaluated using Chi-squared test and multivariate logistic regression. Cohort mean age was 63.6 (12.4) years with 63.3% females. Hypertension (37.8%) was the most common condition. GP visits were made at least once every month (19.1%), every 2–6 months (35.6%), >6 months (11.5%), or only when needed (29.5%). Univariate analyses showed age, education, alcohol consumption, comorbidities, hypertension status, and SRH were significantly associated with visit frequency. After adjustments, hypertension status (OR = 3.6, 95% CI [1.7, 7.9]) and poor SRH (OR = 3.1, 95% CI [1.4, 7.0]) were significantly associated with frequent monthly visits. Our cohort demonstrated that having hypertension and poor self-rated health were associated with frequent monthly GP visits. The perception of high blood pressure does not drive seeking additional GP input.

The effect of multimorbidity on the gap between global and age-comparative self-rated health scores among the Korean elderly

Most of the behavior change models regard perceived health status as a motivation for healthy behaviors or chronic disease self-management. The aim of this study was to examine the association between the number of chronic diseases and the difference between global and age-comparative self-rated health scores (GSRH and ASRH). We used national representative survey data pertaining to the elderly in 2011 from the Korea Institute for Health and Social Affairs. In total, 10,003 participants (≥60 years old) were selected from those who had completed the survey in 2008. Multinomial logistic regression was used to estimate relative risk ratios (RRR) with 95% confidence intervals. Demographic factors, socioeconomic status, social connection, and healthy life style were adjusted. Individuals with many chronic diseases were more likely to have a positive gap, resulting in a better ASRH score relative to GSRH (p for trend <0.001): 1-2 diseases (RRR = 1.30, 95% CI = 1.07-1.57), 3-4 diseases (RRR = 1.90, 95% CI = 1.55-2.32), and ≥5 diseases (RRR = 1.75, 95% CI = 1.39-2.20). In addition, the association between the number of chronic diseases and a positive gap varied by sex and living area. Our results suggest that a positive gap between GSRH and ASRH that indicates an overestimated age-comparative health, was associated with the number of chronic diseases. Female or urban-living people had stronger associations. Further research is needed to understand how the gap between GSRH and ASRH could be an alternative measure of SRH and a predictor of major health outcomes.

Regular source of primary care and emergency department use of children in Victoria

AIM

The aim of this paper was to study the prevalence of a regular source of primary care for Victorian children attending one of four emergency departments (EDs) and to determine associated characteristics, including ED use.

METHODS

Responses were collected via an electronic survey from parents attending EDs with their child (≤9 years of age) for a lower-urgency condition. Single, multiple choice, and Likert scale responses were analysed using bivariate and logistic regression tests.

RESULTS

Of the 1146 parents who provided responses, 80% stated their child has a regular source of primary care. Of these, care is mostly received by a general practitioner (GP) (95%) in GP group practices (71%). Approximately 20% have changed where their child receives primary care in the last year. No associations were observed between having a regular source of primary care and frequency of ED attendance in the past 12 months, although parents whose child did not have a regular source of primary care were more likely to view the ED as a more convenient place to receive care than the primary care provider (39% without regular source vs. 18% with regular source; P < 0.0001). Children were less likely to have a regular source of primary care if their parents were younger, had a lower household income, lower education, and were visiting a hospital in a lower socio-economic indexes for areas rank.

CONCLUSIONS

Policy options to improve continuity of care for children may require investigation. Increasing the prevalence of regular source of primary care for children may in turn reduce ED visits.