The Impact of Respiratory Symptoms on Healthcare Utilisation: The Primary and Secondary Care Interface.

Background: There is evidence that the prevalence of asthma is increasing but little is known about the contribution made by respiratory illness to the combined workload of primary and secondary healthcare.

Aim: To examine the relationship between self-reported respiratory symptoms in adults and health care utilisation.

Methods: Two general practice populations received a postal questionnaire regarding respiratory symptoms in 1993. A random sample of 736 adult respondents was stratified according to number of positive responses to six key questions (to indicate likelihood of asthma diagnosis). Their records were searched for utilisation of healthcare services, to include both primary and secondary sectors.

Results: Positive responses to the key questions were associated with increased relative risk of having a GP consultation, home visit, investigation and prescription issued for lower respiratory problems. Those with higher numbers of positive responses had increased relative risk of out-patient or A & E attendance as well as in-patient admission.

Conclusion: The principal finding of this study is that respiratory symptoms are significantly positively associated with utilisation of health care services for lower and upper respiratory problems. This study provides quantitative evidence of the interface between primary and secondary care in two general practice populations. It provides a method for predicting health care utilisation in both primary and secondary sectors based on reported respiratory symptoms.