title: Trends in self-rated health status and health services use in COPD patients (2006-2012). A Spanish population-based survey.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) patients often have a significant impairment in their health status, which is an independent predictor of health services use.
  
  
  OBJECTIVE
  To describe the self-rated health status and the prevalence of health services use among COPD Spanish patients; to identify which factors are independently associated with a worse health status and a higher use of health services; and to study the time trends in the health status and prevalence of use of health services (2006-2012).
  
  
  METHODS
  Observational study: We analyzed data from the Spanish National Health Surveys conducted in 2006 and 2012. We included responses from adults aged 40 years or over. Subjects described their health status as very good, good, fair, poor, or very poor, which was dichotomized into very good/good or fair/poor/very poor self-perceived health status.
  
  
  RESULTS
  We identified 2,321 COPD patients. The percentage of patients with health status fair, poor, or very poor was 76.8 % in 2006 and 74.8 % in 2012 (p > 0.05). Regarding the health resources use, we observed a significant decrease in the number of visits to primary care over time in women (67.8 vs. 57.2 %, p < 0.05) and men (62.2 vs. 54.0 %, p < 0.05). However, we did not find improvement in the prevalence of emergency department visits or hospitalizations. Associated factors with a worse self-rated health status and a higher use of health services in women and men included: having three or more chronic diseases, presence of mental disorders, and absence of leisure time physical activity.
  
  
  CONCLUSIONS
  The current study revealed a decrease in the general practitioner visits, without changes in use of other health care services in the COPD Spanish population from 2006 to 2012. The self-rated health status did not changed significantly during this period.
authors.affiliation: Department of Respiratory Medicine, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, C/Doctor Esquerdo 46, 28007, Madrid, Spain, javier.miguel@salud.madrid.org.
authors.forename: Javier
authors.initials: J
authors.lastname: de Miguel Díez
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jiménez García
authors.forename: Valentín
authors.initials: V
authors.lastname: Hernández Barrera
authors.forename: Luis
authors.initials: L
authors.lastname: Puente Maestu
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Del Cura González
authors.forename: Manuel
authors.initials: M
authors.lastname: Méndez Bailón
authors.forename: Pilar
authors.initials: P
authors.lastname: Carrasco Garrido
authors.forename: Ana
authors.initials: A
authors.lastname: López de Andrés
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000639:trends; D005260:Female; D058006:General Practice / Q000639:trends; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000706:statistics & numerical data / Q000639:trends*; D006304:Health Status; D006305:Health Status Indicators; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000639:trends; D010043:Outcome and Process Assessment, Health Care / Q000639:trends*; D010342:Patient Acceptance of Health Care; D010361:Patients; D011320:Primary Health Care / Q000639:trends; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D013030:Spain / Q000453:epidemiology; D013997:Time Factors