title: Utilization of health care by patients with multiple sclerosis is based on professional and patient-defined health needs.
abstract: OBJECTIVE
  This cross-sectional study investigates healthcare utilization, and determines which predisposing, enabling, and health factors are associated with healthcare utilization among 121 patients with multiple sclerosis (MS).
  
  
  METHODS
  Data on patient-related predisposing, enabling, and health factors were collected by means of written questionnaires and a home visit from a well-trained physiotherapist.
  
  
  RESULTS
  Of the 121 patients with MS (mean age 43 years, mean score on the Expanded Disability Status Scale 3.5, disease duration 6 years), 16% were hospitalized in the previous year; 62% consulted their general practitioner, and 69% consulted their neurologist in the previous 6 months. Other medical specialists were consulted in the 6-month period by 50% of the study population. In a 4-week period preceding the home visit, 41% of the patients were treated by an allied healthcare professional. Multivariate logistic regression analyses showed that consulting the general practitioner, the neurologist, other medical specialists, and allied healthcare professionals, and the use of equipment/aids by MS patients is primarily related to their health, either as perceived by the patients themselves or defined by the professional.
  
  
  CONCLUSIONS
  MS patients in the Netherlands make appropriate use of healthcare facilities, because their utilization can predominantly be explained by health-related factors, and not by predisposing or enabling factors.
authors.affiliation: Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands. h.beckerman@vumc.nl
authors.forename: H
authors.initials: H
authors.lastname: Beckerman
authors.forename: I E
authors.initials: IE
authors.lastname: van Zee
authors.forename: V
authors.initials: V
authors.lastname: de Groot
authors.forename: G A M
authors.initials: GA
authors.lastname: van den Bos
authors.forename: G J
authors.initials: GJ
authors.lastname: Lankhorst
authors.forename: J
authors.initials: J
authors.lastname: Dekker
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000453:epidemiology / Q000628:therapy*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000453:epidemiology / Q000628:therapy*; D015999:Multivariate Analysis; D020380:Needs Assessment; D009426:Netherlands / Q000453:epidemiology; D009462:Neurology / Q000706:statistics & numerical data; D012112:Residential Facilities / Q000706:statistics & numerical data; D013038:Specialization; D055815:Young Adult