Determinants of costs of care for patients attending primary care

Abstract

Aims: We aimed to evaluate determinants of costs of somatic and psychiatric care for patients attending primary care (PrC). Methods: 495 PrC patients filled in a questionnaire including questions on background, health behaviour, social contacts, perceived health and depressive symptoms. Costs of somatic and psychiatric care were obtained from the local healthcare register. Results: During 5 years’ follow-up, total inflation-adjusted costs of care were 8145 Euros per capita in 2010 prices: 87.2% was due to somatic and 12.8% to psychiatric care. Age associated positively, but being single and working associated negatively with costs of somatic care. Costs of psychiatric care were high in young adults, single, divorced, unemployed, smokers, and those with few social contacts. In zero-inflated multivariate modelling, poor perceived health and being retired increased probability of seeking somatic care. Depressive symptoms and being unemployed increased, and old age decreased probability of seeking psychiatric care. Concerning both services together, poor perceived health and being retired associated with increased, but depressive symptoms with decreased likelihood of being a service user. Among service users, age group 25-44 and having poor perceived health associated with higher costs of care. Female gender, being single, employed, having low education level, regular user of alcohol and regular physical exercise associated with lower costs of care. Conclusions: In patients attending PrC, more than a tenth of total costs of care were due to psychiatric care. Patients’ perceived health associated with costs of somatic, and depressive symptoms with costs of psychiatric care. Sociodemographic background also associated with costs of care.