Determinants of healthcare utilization in Greece: implications for decision-making.
OBJECTIVE
To explore factors influencing the utilization of primary and secondary healthcare in Greece.


METHODS
A national, geographically stratified sample was randomly selected. From November 2001 to March 2002, 5000 questionnaires were mailed, 4427 were actually received, and 1819 were completed and returned (response rate 41%). The questionnaire investigated respondents' characteristics and their health services utilization. A number of potential utilization determinants were explored, such as region, gender, age, education, income, insurance coverage, number of family members, self-rated health status, country of birth, and parents' country of birth.


RESULTS
The utilization of primary healthcare services depended on self-rated health status, age, income, gender, and region. Individuals with moderate and poor self-rated health, older people, women, and residents of the region of Epirus showed increased utilization of primary healthcare services. Income was a factor affecting the utilization of primary healthcare only at lower income levels. The frequency of visits for primary healthcare was negatively correlated with self-rated health status and increased as self-evaluation of health status worsened. Hospitalization was associated with self-rated health and insurance coverage for primary healthcare. Individuals with better self-rated health status, as well as those who were covered by health insurance for primary care, showed decreased hospital care utilization. The frequency of hospitalization depended on region and lower evaluations of health status.


CONCLUSIONS
The findings of our research are encouraging, since they suggest that the utilization of health services in Greece is mostly determined by health status rather than other socioeconomic factors. It is believed that similar studies should be conducted in the country, since they can improve health service planning and reinforce decision-making towards healthcare resource allocation according to healthcare needs.
Geitona
Mary
M
Department of Economics, University of Thessaly, Volos, Greece. geitona@econ.uth.gr
Zavras
Dimitrios
D
Kyriopoulos
John
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003657:Decision Making; D005260:Female; D006115:Greece; D019538:Health Care Surveys; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008875:Middle Aged; D011050:Policy Making; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires