Depressive Symptoms, Lack of Physical Activity, and Their Combination Towards Health Care Utilisation Frequency
Abstract
:1. Introduction
2. Materials and Methods
2.1. Measurements
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Total N = 15,770 | Men N = 7669 | Women N = 8100 | |
---|---|---|---|
Age | |||
15–29 years | 21.5 | 22.5 | 20.6 |
30–64 years | 57.5 | 58.8 | 56.3 |
65+ years | 21.0 | 18.8 | 23.1 |
Education level | |||
Primary | 22.3 | 17.2 | 27.0 |
Secondary | 48.4 | 53.7 | 43.5 |
Tertiary | 29.3 | 29.0 | 29.5 |
Partnership status | |||
Living alone (single, widowed, divorced) | 34.6 | 29.9 | 39.1 |
Living in a partnership | 65.4 | 70.1 | 60.9 |
Smoking status | |||
Currently smoker (yes) | 30.0 | 32.9 | 27.2 |
Currently non-smoker (yes) | 70.0 | 67.1 | 72.8 |
Alcohol | |||
<once a week | 43.5 | 30.4 | 55.9 |
>once a week | 56.5 | 69.6 | 44.1 |
Chronic somatic illnesses and health problems | |||
Bronchial asthma, (yes) | 4.4 | 4.0 | 4.7 |
Chronic Bronchitis, COPD, Emphysema, (yes) | 4.2 | 4.0 | 4.4 |
Heart attack, (yes) | 1.0 | 1.4 | 0.6 |
Coronary heart disease, (yes) | 2.2 | 2.2 | 2.2 |
Blood pressure, (yes) | 21.1 | 20.5 | 21.7 |
Stroke, (yes) | 0.8 | 0.8 | 0.8 |
Arthritis, (yes) | 12.0 | 8.3 | 15.4 |
Chronic back pain, (yes) | 24.4 | 22.9 | 25.8 |
Chronic neck pain, (yes) | 18.5 | 14.1 | 22.7 |
Diabetes mellitus type 2, (yes) | 4.9 | 5.4 | 4.5 |
Allergies, (yes) | 24.2 | 21.8 | 26.5 |
Liver cirrhosis, (yes) | 0.2 | 0.2 | 0.2 |
Urinary incontinence, (yes) | 3.6 | 2.0 | 5.2 |
Chronic kidney problems or kidney failure, (yes) | 1.5 | 1.1 | 1.8 |
Chronic headaches, (yes) | 6.7 | 3.9 | 9.4 |
Stomach or intestinal ulcer, (yes) | 2.5 | 2.3 | 2.7 |
Body mass Index (kg/m2) | |||
Underweight (<18.5 kg/m2) | 2.8 | 1.2 | 4.3 |
Normal weight (18.5–<24.9 kg/m2) | 50.4 | 43.8 | 56.6 |
Overweight (25.0–<29.9 kg/m2) | 32.5 | 39.4 | 25.9 |
Obesity (≥30 kg/m2) | 14.3 | 15.6 | 13.2 |
Outpatient health care utilisation in last 4 weeks | |||
General practitioner, (yes) | 30.8 | 28.7 | 32.8 |
Medical specialist, (yes) | 21.7 | 18.5 | 24.6 |
Hospital outpatient clinic or emergency room, (yes) | 10.8 | 10.6 | 11.0 |
Inpatient health care utilisation in last 12 months | |||
Hospital (yes) | 14.8 | 14.3 | 15.2 |
Health enhancing physical activity | |||
aerobic exercise ≥150 min per week | 50.1 | 53.1 | 47.2 |
aerobic exercise <150 min per week | 49.9 | 46.9 | 52.8 |
Depressive symptoms | |||
0–9 points on the Personal Health Questionnaire Depression Scale | 95.7 | 96.6 | 94.9 |
10–24 points on the Personal Health Questionnaire Depression Scale | 4.3 | 3.4 | 5.1 |
Outpatient Health Care Utilisation | |||||
---|---|---|---|---|---|
All N (%) | Model 1 (Unadjusted) OR (95% CI) | Model 2 OR (95% CI) | Model 3 OR (95% CI) | Model 4 OR (95% CI) | |
Men | |||||
Lack of health enhancing physical activity | 3598 (46.9) | 1.03 (0.94–1.13) | 0.95 (0.86–1.04) | 0.89 (0.81–0.98) | 0.89 (0.80–0.98) |
Depressive symptoms | 260 (3.4) | 2.89 (2.23–3.75) | 2.54 (1.95–3.31) | 1.58 (1.18–2.12) | 1.60 (1.19–2.14) |
Women | |||||
Lack of health enhancing physical activity | 4276 (52.8) | 1.17 (1.07–1.28) | 1.14 (1.04–1.28) | 1.06 (0.97–1.16) | 1.05 (0.96–1.15) |
Depressive symptoms | 413 (5.1) | 2.98 (2.39–3.72) | 3.04 (2.43–3.80) | 2.10 (1.66–2.66) | 2.10 (1.65–2.66) |
Inpatient Health Care Utilisation | |||||
---|---|---|---|---|---|
All N (%) | Model 1 (Unadjusted) OR (95% CI) | Model 2 OR (95% CI) | Model 3 OR (95% CI) | Model 4 OR (95% CI) | |
Men | |||||
Lack of health enhancing physical activity | 3598 (46.9) | 1.07 (0.94–1.21) | 0.98 (0.86–1.12) | 0.90 (0.78–1.03) | 0.89 (0.78–1.03) |
Depressive symptoms | 260 (3.4) | 2.74 (2.09–3.60) | 2.54 (1.91–3.37) | 1.50 (1.09–2.08) | 1.52 (1.09–2.10) |
Women | |||||
Lack of health enhancing physical activity | 4276 (52.8) | 1.32 (1.17–1.50) | 1.24 (1.09–1.40) | 1.08 (0.95–1.23) | 1.06 (0.93–1.21) |
Depressive symptoms | 413 (5.1) | 2.70 (2.16–3.34) | 2.76 (2.20–3.44) | 2.10 (1.64–2.69) | 2.09 (1.64–2.68) |
Lack of Health Enhancing Physical Activity | Depressive Symptoms | Health Care Utilisation, N (%) | Model 1 OR (95% CI) | Model 2 OR (95% CI) | Model 3 OR (95% CI) |
---|---|---|---|---|---|
Men | |||||
+ | + | 108 (65.5) | 2.89 (2.08–4.00) | 2.28 (1.63–3.18) | 1.43 (0.99–2.07) |
- | + | 62 (65.3) | 2.92 (1.90–4.48) | 2.73 (1.76–4.22) | 1.51 (0.95–2.41) |
+ | - | 1362 (39.7) | 1.01 (0.92–1.11) | 0.93 (0.85–1.03) | 0.89 (0.80–0.98) |
- | - | 1571 (39.5) | 1 | 1 | 1 |
Synergy index | 0.98 (0.44–2.19) | 0.77 (0.31–1.92) | 0.19 (0.14–8.72) | ||
Attributable proportion | −0.02 (−0.55–0.52) | −0.17 (−0.81–0.47) | 0.02 (−0.57–0.62) | ||
Relative excess risk due to interaction | −0.04 (−1.58–1.50) | −0.38 (−1.77–1.01) | 0.03 (−0.82–0.89) | ||
Women | |||||
+ | + | 195 (73.0) | 3.28 (2.48–4.33) | 3.22 (2.43–4.26) | 2.02 (1.50–2.73) |
- | + | 106 (72.1) | 3.10 (2.14–4.46) | 3.26 (2.26–4.72) | 2.40 (1.64–3.52) |
+ | - | 1960 (48.9) | 1.15 (1.05–1.26) | 1.12 (1.03–1.23) | 1.06 (0.97–1.17) |
- | - | 1671 (45.4) | 1 | 1 | 1 |
Synergy index | 1.01 (0.35–2.98) | 0.93 (0.94–1.76) | 0.70 (0.31–1.60) | ||
Attributable proportion | 0.01 (−0.23–0.75) | −0.05 (−0.52–0.42) | −0.22 (0.78–0.34) | ||
Relative excess risk due to interaction | 0.03 (−2.39–2.45) | −0.17 (−1.64–1.31) | −0.44 (−1.51–0.63) |
Lack of Health Enhancing Physical Activity | Depressive Symptoms | Health Care Utilisation, N (%) | Model 1 OR (95% CI) | Model 2 OR (95% CI) | Model 3 OR (95% CI) |
---|---|---|---|---|---|
Men | |||||
+ | + | 55 (33.3) | 3.16 (2.26–4.42) | 2.64 (1.86–3.75) | 1.52 (1.02–2.26) |
- | + | 24 (25.3) | 2.13 (1.33–3.42) | 2.14 (1.32–3.50) | 1.19 (0.64–2.04) |
+ | - | 473 (13.8) | 1.01 (0.89–1.16) | 0.94 (0.82–1.08) | 0.88 (0.76–1.01) |
- | - | 542 (13.6) | 1 | 1 | 1 |
Synergy index | 0.45 (0.22–0.93) | 1.51 (0.50–4.54) | 7.57 (0.00–130,362) | ||
Attributable proportion | −0.84 (−1.88–0.20) | 0.21 (−0.26–0.68) | 0.30 (−0.19–0.78) | ||
Relative excess risk due to interaction | −2.65 (−5.54–0.25) | 0.55 (−0.81–1.91) | 0.45 (−0.39–1.28) | ||
Women | |||||
+ | + | 78 (29.2) | 2.89 (2.18–3.83) | 2.72 (2.04–3.63) | 1.75 (1.28–2.40) |
- | + | 51 (34.7) | 3.70 (2.60–5.27) | 4.05 (2.82–5.82) | 3.49 (2.40–5.01) |
+ | - | 646 (16.1) | 1.34 (1.18–1.53) | 1.26 (1.11–1.44) | 1.13 (0.99–1.30) |
- | - | 460 (12.5) | 1 | 1 | 1 |
Synergy index | 0.62 (0.35–1.11) | 0.52 (0.29–0.95) | 0.29 (0.13–0.65) | ||
Attributable proportion | −0.40 (−0.98–0.18) | −0.59 (−1.26–0.09) | −1.07 (−2.00 to −0.14) | ||
Relative excess risk due to interaction | −1.16 (−2.65–0.34) | −1.59 (−3.20–0.01) | −1.87 (−3.25 to −0.50) |
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Haider, S.; Grabovac, I.; Rieder, A.; Dorner, T.E. Depressive Symptoms, Lack of Physical Activity, and Their Combination Towards Health Care Utilisation Frequency. Int. J. Environ. Res. Public Health 2019, 16, 4697. https://doi.org/10.3390/ijerph16234697
Haider S, Grabovac I, Rieder A, Dorner TE. Depressive Symptoms, Lack of Physical Activity, and Their Combination Towards Health Care Utilisation Frequency. International Journal of Environmental Research and Public Health. 2019; 16(23):4697. https://doi.org/10.3390/ijerph16234697
Chicago/Turabian StyleHaider, Sandra, Igor Grabovac, Anita Rieder, and Thomas Ernst Dorner. 2019. "Depressive Symptoms, Lack of Physical Activity, and Their Combination Towards Health Care Utilisation Frequency" International Journal of Environmental Research and Public Health 16, no. 23: 4697. https://doi.org/10.3390/ijerph16234697