Health service utilisation associated with chronic breathlessness: random population sample.

Currow, DC; Chang, S; Ekström, M; Hutchinson, A; Luckett, T; Kochovska, S; Hay, P; Touyz, S; Dal Grande, E; Johnson, MJ

Health service utilisation associated with chronic breathlessness: random population sample.

Currow, DC Chang, S

Ekström, M Hutchinson, A Luckett, T

Kochovska, S

Hay, P Touyz, S Dal Grande, E Johnson, MJ

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Publisher:: European Respiratory Society
Publication Type:: Journal Article
Citation:: ERJ Open Research, 2021, 7, (4)
Issue Date:: 2021-10-11

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Field	Value	Language
dc.contributor.author	Currow, DC
dc.contributor.author	Chang, S https://orcid.org/0000-0003-0723-3192
dc.contributor.author	Ekström, M
dc.contributor.author	Hutchinson, A
dc.contributor.author	Luckett, T https://orcid.org/0000-0001-6121-5409
dc.contributor.author	Kochovska, S https://orcid.org/0000-0002-3531-0389
dc.contributor.author	Hay, P
dc.contributor.author	Touyz, S
dc.contributor.author	Dal Grande, E
dc.contributor.author	Johnson, MJ
dc.date.accessioned	2021-11-09T04:39:49Z
dc.date.available	2021-08-04
dc.date.available	2021-11-09T04:39:49Z
dc.date.issued	2021-10-11
dc.identifier.citation	ERJ Open Research, 2021, 7, (4)
dc.identifier.issn	2312-0541
dc.identifier.issn	2312-0541
dc.identifier.uri	http://hdl.handle.net/10453/151442
dc.description.abstract	Background Most health service utilisation studies are of people with specific diagnoses or demographic characteristics, and rarely of specific chronic symptoms. The aim of this study was to establish whether population-level health service utilisation increases in people with chronic breathlessness. Methods A cross-sectional analysis was carried out of the South Australian Health Omnibus Survey 2017, a multi-stage, clustered area, systematic sampling survey of adults where questions are administered face-to-face in respondents’ homes. Self-report of health service utilisation in the previous 3 months (medical consultations, emergency department, hospital admission), chronic breathlessness (severity, duration, modified Medical Research Council (mMRC) breathlessness scale) and demographic data were used to predict self-reported health service utilisation. Results A total of 2898 people were included (49.0% male; median age 48.0 years (IQR 32.0–63.0); 64.1% educated beyond school; 55.4% in work; 73.5% had outpatient contact; 6.3% had a hospital admission in the previous 3 months). Chronic breathlessness (mMRC ≥1) was reported by 8.8% of respondents. In bivariable analyses, people with greater contact with health services were older, and a higher proportion were overweight/obese and had more severe chronic breathlessness. In multivariable analyses, chronic breathlessness and older age were positively associated with outpatient care and inpatient care, and people with chronic breathlessness were hospitalised for longer (incidence rate ratio 2.5; 95% CI 1.4–4.5). Conclusion There is a significant association between worse chronic breathlessness and increased health service utilisation. There is a need for greater understanding of factors that initiate contact with health services.
dc.format	Electronic-eCollection
dc.language	eng
dc.publisher	European Respiratory Society
dc.relation.ispartof	ERJ Open Research
dc.relation.isbasedon	10.1183/23120541.00415-2021
dc.rights	info:eu-repo/semantics/openAccess
dc.title	Health service utilisation associated with chronic breathlessness: random population sample.
dc.type	Journal Article
utslib.citation.volume	7
utslib.location.activity	England
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2021-11-09T04:39:47Z
pubs.issue	4
pubs.publication-status	Published
pubs.volume	7
utslib.citation.issue	4

Abstract:

Background Most health service utilisation studies are of people with specific diagnoses or demographic characteristics, and rarely of specific chronic symptoms. The aim of this study was to establish whether population-level health service utilisation increases in people with chronic breathlessness. Methods A cross-sectional analysis was carried out of the South Australian Health Omnibus Survey 2017, a multi-stage, clustered area, systematic sampling survey of adults where questions are administered face-to-face in respondents’ homes. Self-report of health service utilisation in the previous 3 months (medical consultations, emergency department, hospital admission), chronic breathlessness (severity, duration, modified Medical Research Council (mMRC) breathlessness scale) and demographic data were used to predict self-reported health service utilisation. Results A total of 2898 people were included (49.0% male; median age 48.0 years (IQR 32.0–63.0); 64.1% educated beyond school; 55.4% in work; 73.5% had outpatient contact; 6.3% had a hospital admission in the previous 3 months). Chronic breathlessness (mMRC ≥1) was reported by 8.8% of respondents. In bivariable analyses, people with greater contact with health services were older, and a higher proportion were overweight/obese and had more severe chronic breathlessness. In multivariable analyses, chronic breathlessness and older age were positively associated with outpatient care and inpatient care, and people with chronic breathlessness were hospitalised for longer (incidence rate ratio 2.5; 95% CI 1.4–4.5). Conclusion There is a significant association between worse chronic breathlessness and increased health service utilisation. There is a need for greater understanding of factors that initiate contact with health services.

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http://hdl.handle.net/10453/151442