Evaluation of self-rated health – information on patients’ unmet needs?

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Background: Self-rated health (SRH) reflects a person’s experience of their own health, including the biological, sociological and psychological factors. It is frequently used in population studies but can provide primary physicians with additional information regarding patients’ needs.

Objectives: To analyse determinants of SRH according to physical health, patient demographic characteristics and frequency of practice attendance.

Methods: Analysed data derived from the national part of the EPA-Cardio project. Several patient characteristics and SRH as an outcome measure were analysed in three groups of patients: with coronary disease, with high risk for cardiovascular disease and with low risk for cardiovascular disease, randomly chosen from the practice registers and lists of 36 practices.

Results: 2524 patients participated (response rate 70.1%). Coronary patients and those with the highest number of chronic diseases rated their health the lowest. Low SRH was found in women, older patients, the unemployed and in patients with a lower level of education. Low SRH was associated with higher body weight, lower satisfaction with the practice and a higher number of practice visits.

Conclusion: Several determinants were shown to be important for SRH. Physical health reflected by chronic disease and multimorbidity and life-style determined by body weight were shown to be important for SRH in the population of family practice. Socio-economic characteristics (employment, education level) were also reflected in SRH. Lower SRH, associated with higher frequency of attendance of the practice and lower satisfaction with the practice, points to the unmet needs of the patients.

1. The EuroQol Group. EuroQol - a new facility for the measurement of health-related quality of life. Health Policy 1990; 16: 199-208.

2. Feeny D, William F, Michael B, Torrance GW. Multi-attribute health status classification systems: Health Utilities Index.Pharmacoeconomics 1995; 7: 490-502.

3. Undén AL, Elofsson S. Health from the patient‘s point of view: how does it relate to the physician‘s judgement? Fam Pract 2001; 18: 174-80.

4. Krause NM, Jay GM. What do global self-rated health items measure? Med Care 1994; 32: 930-42.

5. Heistaro S, Jousilahti P, Lahelma E, Vartiainen E, Puska P.Self rated health and mortality: a long term prospective study in eastern Finland. J Epidemiol Community Health 2001; 55: 227-32.

6. Heidrich J, Liese AD, Löwel H, Keil U.Self-rated health and its relation to all-cause and cardiovascular mortality in southern Germany: results from the MONICA Augsburg cohort study 1984-1995. Ann Epidemiol 2002; 12: 338-45.

7. Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 1997; 38: 21-37.

8. Nery Guimarães JM, Chor D, Werneck GL, Carvalho MS, Coeli CM, Lopes CS, Faerstein E. Association between self-rated health and mortality: 10 years follow-up to the Pró-Saúde cohort study. BMC Public Health 2012; 12: 676.

9. Bopp M, Braun J, Gutzwiller F, Faeh D, Swiss National Cohort Study Group. Health risk or resource? Gradual and independent association between self-rated health and mortality persists over 30 years. PLoS One 2012; 7: e30795.

10. Benyamini Y, Blumstein T, Lusky A, Modan B. Gender differences in the self-rated health-mortality association: is it poor self-rated health that predicts mortality or excellent self-rated health that predicts survival? Gerontologist 2003; 43: 396-405.

11. Griffiths P, Ullman R, Harris R. Self assessment of health and social care needs by older people: a multi-method systematic review of practices, accuracy, effectiveness and experience.Available Feb 19, 2013 at: http://www.netscc.ac.uk/hsdr/files/project/SDO_FR_08-1204-030_V01.pdf.

12. Rohrer JE, Merry SP, Rohland B, Rasmussen N, Wilshusen L. Physical limitations and self-rated overall health in family medicine patients. Clin Rehabil 2008; 22 :38-44.

13. Anson O, Paran E, Neumann L, Chernichovsky D. Gender differences in health perceptions and their predictors. Soc Sci Med 1993; 36: 419-27.

14. Parslow R, Jorm A, Christensen H, Jacomb P, Rodgers B.Gender differences in factors affecting use of health services: an analysis of a community study of middle-aged and older Australians. Soc Sci Med 2004; 59: 2121-9.

15. Linn MW, Linn BS, Skyler JS, Harris R. The importance of selfassessed health in patients with diabetes. Diabetes Care 1980; 3: 599-606.

16. Farkas J, Pahor M, Zaletel-Kragelj L. Self-rated health in different social classes of Slovenian adult population: nationwide cross-sectional study. Int J Public Health 2011; 56: 45-54.

17. Farkas J, Kosnik M, Zaletel-Kragelj L, Flezar M, Suskovic S, Lainscak M. Distribution of self-rated health and association with clinical parameters in patients with chronic obstructive pulmonary disease. Wien Klin Wochenschr 2009; 121: 297-302.

18. Layes A, Asada Y, Kepart G. Whiners and deniers - what does self-rated health measure? Soc Sci Med 2012; 75: 1-9.

19. Klemenc-Ketis Z, Smogavec M, Softic N, Kersnik J. Healthrelated quality of life: a population based study from Slovenia.Cent Eur J Public Health 2011; 19: 7-12.

20. Klemenc-Ketis Z, Kersnik J, Eder K, Colaric D. Factors associated with health-related quality of life among university students. Srp Arh Celok Lek 2011; 139: 197-202.

21. Cerne A, Rifel J, Rotar-Pavlic D, Svab I, Selic P, Kersnik J.Quality of life in patients with depression, panic syndrome, other anxiety syndrome, alcoholism and chronic somatic diseases: a longitudinal study in Slovenian primary care patients. Wien Klin Wochenschr 2012; 125: 1-7.

22. Wensing M, Ludt S, Campbell S et al. European Practice Assessment of Cardiovascular risk management (EPA Cardio): protocol of an international observational study in primary care.Implement Sci 2009; 4: 3.

23. Vos HM, Bor HH, van Rangelrooij-Minkels MJ, Schellevis FG, Lagro-Janssen AL. Multimorbidity in older women: the negative impact of specific combinations of chronic conditions on selfrated health. Eur J Gen Pract 2013; 19: 117-22.

24. Laaksonen M, Talala K, Martelin T, Rahkonen O, Roos E, Helakorpi S et al. Health behaviours as explanations for educational level differences in cardiovascular and all-cause mortality: a follow-up of 60 000 men and women over 23 years.Eur J Public Health 2008; 18: 38-43.

25. Arnsberger P, Lynch U, Li F. The effects of caregiving on women‘s self -assessed health status: an international comparison. Health Care Women Int 2012; 33: 878-95.

26. Heistaro S, Laatikainen T, Vartiainen E, Puska P, Uutela A, Pokusajeva S et al. Self-reported health in the Republic of Karelia, Russia and in north Karelia, Finland in 1992. Eur J Public Health 2001; 11: 74-80.

27. Kersnik J, Švab I, Vegnuti M. Frequent attenders in general practice: quality of life, patient satisfaction, use of medical services and GP characteristics. Scan J Prim Health Care 2001; 19: 174-7.

28. Jylha M. What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med 2009; 69: 307-16.

29. Selič P, Petek D, Serec M, Makovec MR. Self-rated health and its relationship to health/ life problems and coping strategies in members of the professional Slovenian armed forces. Coll Antropol 2012; 36: 1175-82.

30. Okosun IS, Choi S, Matamoros T, Dever GE: Obesity is associated with reduced self-rated general health status: evidence from a representative sample of white, black, and Hispanic Americans. Prev Med 2001; 32429-36.

31. Prosper MH, Moczulski VL, Qureshi A: Obesity as a predictor of self-rated health. Am J Health Behav 2009; 33: 319-29.

32. Møller L, Kristensen TS, Hollnagel H.Self rated health as a predictor of coronary heart disease in Copenhagen, Denmark. J Epidemiol Community Health 1996; 50: 423-8.

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