Predicting health care use among older osteoarthritis patients in an HMO

OBJECTIVE: To determine factors that predict health care use among members of Health Maintenance Organizations (HMOs). Demographic, health, and psychological factors were examined simultaneously. METHODS: Participants were HMO members 60 years of age or older who had osteoarthritis (OA). All participants reported symptoms of OA, with 90% of the diagnoses confirmed by evaluation of physician records. RESULTS: Age, the presence of other medical conditions, quality of well-being, and the Health Worries subscale from the Arthritis Impact Measurement Scales accounted for 11.2% of the total variance in health care contacts. A model including prior health care use, age, quality of well-being, physical impairment, and pain accounted for 29.5% of the variance in utilization rates. CONCLUSION: The best single predictor of health care utilization was prior use of the system. Being older, more impaired, and having lower well-being scores were also predictors of health care use.