title: Sleep quality and health service utilization in Chinese general population: a cross-sectional study in Dongguan, China.
abstract: The aims of this study were to explore the Pittsburgh Sleep Quality Index (PSQI) and health service utilization in Chinese general population, to investigate the association between PSQI and health service utilization and to identify the independent contributions of social demographic variables, health related factors and PSQI to health service utilization.
  
  
  
  In a cross-sectional community-based health survey using a multi-instrument questionnaire, 4067 subjects (≥15 years old) were studied. The Chinese version of the PSQI was used to assess sleep quality. Health service utilization was measured by recent two-week physician visit and annual hospitalization rates.
  
  
  
  Higher PSQI scores were associated with more frequent health service utilization. Higher scores in subjective sleep quality were associated with higher rate of recent two-week physician visit (adjusted OR = 1.24 per SD increase, P = 0.015). Higher scores in habitual sleep efficiency (adjusted OR = 1.24 per SD increase, P = 0.038) and sleep disturbances (adjusted OR = 2.09 per SD increase, P < 0.001) were associated with more frequent annual hospitalization. The independent influence of PSQI on the risk of recent two-week physician visit was 0.7%, and that of annual hospitalization 31.4%.
  
  
  
  Poorer sleep quality predicted more frequent health service utilization. The independent contribution of PSQI on health service utilization was smaller than social demographic variables.
authors.affiliation: Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China. Electronic address: zhanghuishan25@163.com.
authors.forename: Hui-Shan
authors.initials: HS
authors.lastname: Zhang
authors.affiliation: Shenzhen Guangming New District People's Hospital, China. Electronic address: 283615557@qq.com.
authors.forename: Yan-Bing
authors.initials: YB
authors.lastname: Mai
authors.affiliation: Guangdong Pharmaceutical University, China. Electronic address: liweida123@126.com.
authors.forename: Wei-Da
authors.initials: WD
authors.lastname: Li
authors.affiliation: Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China. Electronic address: allan0225@126.com.
authors.forename: Wen-Tao
authors.initials: WT
authors.lastname: Xi
authors.affiliation: Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China. Electronic address: Wangjm106@163.com.
authors.forename: Jin-Ming
authors.initials: JM
authors.lastname: Wang
authors.affiliation: Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China. Electronic address: gz-leizeng@163.com.
authors.forename: Yi-Xiong
authors.initials: YX
authors.lastname: Lei
authors.affiliation: Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China. Electronic address: peixi001@163.com.
authors.forename: Pei-Xi
authors.initials: PX
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000628:therapy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Chinese; Health service utilization; Pittsburgh Sleep Quality Index; Sleep quality