{'fraction_non_alphanumeric': 0.017041581458759374, 'fraction_numerical': 0.010906612133605999, 'mean_word_length': 4.7795275590551185, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Psychological distress and use of ambulatory medical services in the Quebec Medicare system.

OBJECTIVE
To document the impact of psychological distress symptoms on the use of ambulatory medical services in a universal insurance coverage context.


DATA SOURCES
Data from the Quebec Health Survey (1987) linked with billing data from the Quebec Medicare system. The time frame for the utilization variables is one year before and one year after the QHS survey.


STUDY DESIGN
LISREL was used to test a model introducing perceived health need as an explanatory factor of the relationship between psychological distress and the number of visits to a physician. Two samples were formed from the matched file. Sample A (n = 2,000) was used in an exploratory phase to adequately specify the model. Sample B (n = 2,000) was used to confirm the results obtained with Sample A.


PRINCIPAL FINDINGS
The proposed model explained 35 percent of the number of visits to a physician in Sample A and 24 percent in Sample B. The effect of psychological distress symptoms on the respondent's perceived health need was as important as the effect of physical health status. The effect of the respondent's previous health services utilization on the number of visits to a physician was also significant.


CONCLUSIONS
These results may be interpreted to indicate that in a universal insurance coverage context, psychological distress is a significant predictor of perceived health need.