title: Psychological distress and use of ambulatory medical services in the Quebec Medicare system.
abstract: OBJECTIVE
  To document the impact of psychological distress symptoms on the use of ambulatory medical services in a universal insurance coverage context.
  
  
  METHODS
  Data from the Quebec Health Survey (1987) linked with billing data from the Quebec Medicare system. The time frame for the utilization variables is one year before and one year after the QHS survey.
  
  
  METHODS
  LISREL was used to test a model introducing perceived health need as an explanatory factor of the relationship between psychological distress and the number of visits to a physician. Two samples were formed from the matched file. Sample A (n = 2,000) was used in an exploratory phase to adequately specify the model. Sample B (n = 2,000) was used to confirm the results obtained with Sample A.
  
  
  RESULTS
  The proposed model explained 35 percent of the number of visits to a physician in Sample A and 24 percent in Sample B. The effect of psychological distress symptoms on the respondent's perceived health need was as important as the effect of physical health status. The effect of the respondent's previous health services utilization on the number of visits to a physician was also significant.
  
  
  CONCLUSIONS
  These results may be interpreted to indicate that in a universal insurance coverage context, psychological distress is a significant predictor of perceived health need.
authors.affiliation: Gerontology Research Center, Sherbrooke Geriatric University Institute, Québec, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Préville
authors.forename: L
authors.initials: L
authors.lastname: Potvin
authors.forename: R
authors.initials: R
authors.lastname: Boyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006302:Health Services Research; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009313:National Health Programs / Q000706:statistics & numerical data; D009819:Office Visits / Q000706:statistics & numerical data*; D011792:Quebec; D018855:Single-Payer System; D013315:Stress, Psychological / Q000150:complications*