Low education, high GP consultation rates: the effect of psychosocial factors

J Psychosom Res. 1998 May;44(5):587-97. doi: 10.1016/s0022-3999(97)00217-1.

Abstract

The purpose of this study was to estimate the contribution of psychosocial factors to the increased use of a general practitioner (GP) among those with a lower level of education. The use of GP services was elicited from survey data from 2867 respondents from the Dutch Longitudinal Study on Socio-Economic Differences in the Utilization of Health Services (LS-SEDUHS) using a simple "Yes/ No" format. Psychosocial variables included long-term stressful conditions, social support, external locus of control, coping styles, and tendency to consult (a measure of people's propensity to go to a doctor with health problems). People with primary education used the GP services more than people with higher vocational training or a university degree (OR 1.87, p<0.05), adjusted for health status and health insurance. Only tendency to consult partially explained this difference (OR: 1.74, p>0.05). Most psychosocial factors do not seem very important in explaining high GP utilization rates among those with a low socioeconomic status. Alternative explanations are discussed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Aged
  • Chi-Square Distribution
  • Cohort Studies
  • Confidence Intervals
  • Cross-Sectional Studies
  • Educational Status
  • Female
  • Health Care Surveys
  • Humans
  • Internal-External Control
  • Least-Squares Analysis
  • Logistic Models
  • Male
  • Middle Aged
  • Models, Psychological
  • Netherlands
  • Odds Ratio
  • Patient Acceptance of Health Care / psychology*
  • Primary Health Care / statistics & numerical data*
  • Social Class*
  • Social Support