title: The pattern of health care utilization of elderly people with arthritic pain in the hip or knee.
abstract: OBJECTIVE
  The aim of the study was to determine the pattern of health care utilization of people aged 55-74 years with arthritic pain in the knee or hip.
  
  
  METHODS
  People with current pain were identified in a population-based study. A filter model was used to describe the pattern of health care utilization of people who presented as patients at different levels (GPs or specialist) of the health care system in the Netherlands.
  
  
  METHODS
  The study was carried out in the district of Ommoord in Rotterdam in an age- and gender-representative sample of 831 (response 83%; n = 691) people.
  
  
  METHODS
  A group of 186 people with current pain was identified. They completed a questionnaire and were interviewed.
  
  
  METHODS
  Background variables, illness-related variables (including radiological osteoarthritis), and self-reported diagnoses were described and compared for attenders and non-attenders of GPs and specialists. A reference group of patients of GPs was used to determine the validity and generalizability of the findings.
  
  
  RESULTS
  Eighty-two per cent consulted a GP (passed filter 1). In 69% of the GP attenders, 'arthritis' was identified (passed filter 2), and 65% of them attended a specialist (passed filter 3). People who did not pass the various filters were different from those who did with respect to the body mass index (lower; OR 1.24), the chronicity of pain (less chronic pain; OR 4.9) and attendance of a physiotherapist (lower; OR 5.6). The chronicity of pain seems of more importance in determining the health care utilization pattern than the severity of pain, the level of disability or the presence of radiological osteoarthritis. We suggest that health promotion interventions could increase the self-management ability of patients and could lower costs.
authors.affiliation: TNO Prevention and Health, Division Public Health and Prevention, Leiden, The Netherlands. M.Hopman@pg.tno.nl
authors.forename: M
authors.initials: M
authors.lastname: Hopman-Rock
authors.forename: G H
authors.initials: GH
authors.lastname: de Bock
authors.forename: J W
authors.initials: JW
authors.lastname: Bijlsma
authors.forename: M P
authors.initials: MP
authors.lastname: Springer
authors.forename: A
authors.initials: A
authors.lastname: Hofman
authors.forename: F W
authors.initials: FW
authors.lastname: Kraaimaat
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data*; D006621:Hip Joint; D006801:Humans; D007719:Knee Joint; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D010003:Osteoarthritis / Q000453:epidemiology / Q000534:rehabilitation; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D012017:Referral and Consultation; D014600:Utilization Review / Q000706:statistics & numerical data