Factors related to self-rated health: a survey among patients and their general practitioners

OBJECTIVE: To explore associations between general practice patients’ SRH and symptoms, diagnoses, chronic conditions, unexplained conditions, and life stressors. DESIGN: A cross-sectional study. Data were collected from GP and patient questionnaires. SETTING: General practices in Southeast Norway. SUBJECTS: 47 general practitioners (GPs) who included 866 consecutive patients. MAIN OUTCOME MEASURES: SRH was measured with a single question from the COOP-WONCA overall health chart and dichotomized into good/poor SRH. Binary logistic regression models were used in the analyses. RESULTS: Poor SRH was reported by 48% of the patients in the past week. A higher prevalence of poor SRH was found for women, middle-aged, recipients of social security grants, patients diagnosed with asthenia, lower back pain, and depression/anxiety, and for patients with reported life stressors and unexplained conditions. We found an almost linear association between the number of symptoms and the likelihood of reporting poor SRH. The probability of reporting poor SRH increased along with an increasing number of symptoms for common diagnoses. In a multivariate analysis, the only number of symptoms, being in receipt of social security grants and being retired was associated with poor SRH. CONCLUSION: The likelihood of reporting poor SRH increased with an increasing number of symptoms, partly independent of the diagnosis given by GPs. This result coincides with our previous findings of a strong association between the number of symptoms, function, and health. The symptom burden thus appears to be an important factor for SRH among patients in general practice. KEY POINTS: There is a high prevalence of poor SRH in general practice patients. The likelihood of reporting poor SRH is partly independent of the diagnosis given. The number of symptoms was the factor strongest associated with poor SRH.