title: Respiratory symptoms increase health care consumption and affect everyday life - a cross-sectional population-based study from Finland, Estonia, and Sweden.
abstract: BACKGROUND
  Even though respiratory symptoms are common in the adult population, there is limited research describing their impact on everyday life and association with health care consumption.
  
  
  OBJECTIVE
  The main objective of this population-based study was to estimate and compare the prevalence of respiratory symptoms among adults in Finland, Estonia, and Sweden in relation to health care consumption and to identify factors influencing health care consumption. A secondary aim was to assess to which extent the presence of respiratory symptoms affect everyday life.
  
  
  METHODS
  In the population-based FinEsS studies consisting of random samples of subjects aged 20 to 69 years from Finland (n=1,337), Estonia (n=1,346), and Sweden (n=1,953), data on demographics, respiratory health, and health care consumption were collected by structured interviews. Prevalence was compared and multiple logistic regression analyses were performed.
  
  
  RESULTS
  Respiratory symptoms were significantly more common in Finland (66.0%) and Estonia (65.2%) than in Sweden (54.1%). Among subjects with respiratory symptoms, the proportion reporting outpatient care during the past year was fairly similar in the three countries, while specialist consultations were more common in Finland (19.1%), and hospitalisations more common in Estonia (15.0%). Finnish and Estonian residency, female sex, and BMI>25 increased the risk for outpatient care consumption. Wheeze and attacks of shortness of breath in the past 12 months, recurrent sputum production, and cough were associated with an increased risk for health care consumption. Increasing number of respiratory symptoms increased the risk for consuming health care. A larger proportion of subjects in Estonia and Sweden experienced their everyday life being affected by respiratory symptoms compared with subjects in Finland.
  
  
  CONCLUSIONS
  Respiratory symptoms are common in Finland, Estonia, and Sweden and contribute to a negative impact on everyday life as well as increased health care consumption. The observed differences in health care consumption between countries are probably related to national differences in health care structure.
authors.affiliation: Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden; malin.axelsson@mah.se.
authors.forename: Malin
authors.initials: M
authors.lastname: Axelsson
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Medicine, The OLIN Unit, Umeå University, Umeå, Sweden.
authors.forename: Anne
authors.initials: A
authors.lastname: Lindberg
authors.affiliation: HUCH Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
authors.forename: Annette
authors.initials: A
authors.lastname: Kainu
authors.affiliation: Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, Umeå University, Umeå, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Rönmark
authors.affiliation: Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, Umeå University, Umeå, Sweden.
authors.forename: Sven-Arne
authors.initials: SA
authors.lastname: Jansson
keywords: daily life; epidemiology; health care utilisation; respiratory symptoms; risk factors; structured interviews