Socio-economic status, chronic morbidity and health services utilization by families

This study deals with the perception of the burden of chronic morbidity in general practice. A married couple of general practitioners work in two primary health centres in Madrid (Spain), with populations of different socio-economic status: one deprived, another of medium and high class.

The couple try to understand their feelings about a higher prevalence and severity of chronic morbidity in the poor district.

A transversal observational study was designed. A total of 119 patients aged 50-70 years were interviewed after the medical encounter. Data were obtained about (i) patients' sociodemographic conditions; (ii) structure and economic status of the families; and (iii) chronic morbidity and health services utilization of family members.

Families in the deprived district included members of more than two generations in 76.5% of cases (18.8% in the comparison district); 70.3% of the heads of the families (main economic support) were pensioners in the poor district (23.7% in the comparison district); patients in the deprived district have more contacts with the health system and more chronic morbidity; families in the poor area have less expressiveness and cohesion and more irritability and negation.

Perceived morbidity in general practice is a mix of social and family problems as well as number and severity of chronic health problems and health services utilization.