title: Influence of health-related quality of life on health service utilization in addition to socio-demographic and morbidity variables among primary care patients in China.
abstract: OBJECTIVE
  We aimed to investigate whether health-related quality of life (HRQOL) influences health service utilization and whether such influence exists independently in addition to socio-demographic and morbidity variables.
  
  
  METHODS
  A retrospective design was carried out among 737 primary care patients in mainland China. Health service utilization was measured by the number of monthly outpatient consultations and the annual hospitalization rate. HRQOL was measured by the SF-36. A clustered regression model was adopted throughout the analysis.
  
  
  RESULTS
  Lower HRQOL was associated with a higher utilization rate. Three out of the eight SF-36 subscales were associated with outpatient consultation, and additional two with inpatient consultation. One subscale of the SF-36 (mental health) was associated with an independent influence of 11.8% with outpatient consultation, and another subscale of the SF-36 (general health) was associated with an independent influence of 26.0% with inpatient consultation.
  
  
  CONCLUSIONS
  Health service utilization increased significantly with decreasing HRQOL, and the independent influence of HRQOL on health service utilization was smaller than that of socio-demographic and morbidity variables among primary care patients in mainland China.
authors.affiliation: Institute of Social and Family Medicine, Zhejiang University, Zijingang Campus, Mailbox 25, No. 388, Yuhangtan Road, 310058, Hangzhou, China.
authors.forename: Tianhui
authors.initials: T
authors.lastname: Chen
authors.forename: Lu
authors.initials: L
authors.lastname: Li
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002681:China; D002908:Chronic Disease; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011788:Quality of Life; D012189:Retrospective Studies; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
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