Correlates of the use of health services among elementary school teachers: A cross-sectional exploratory study

Abstract

The aim of the present study was to analyze the use of health services and associated factors among elementary school teachers. This is a cross-sectional study conducted with 505 school teachers from Londrina-PR, Brazil. The outcomes were medical consultation, emergency service, hospitalization, other consultations and laboratory and imaging exam use. Work and health characteristics were the independent variables. All variables were assessed using a self-report questionnaire and negative binomial regression was adopted to estimate rate ratios (RR). Sedentary behavior, being overweight, physical activity, alcohol consumption, tobacco use, burnout and high stress were not associated with any outcome. The presence of chronic diseases (RR = 1.27 to 4.25) and disability due to musculoskeletal disorders (RR = 1.25 to 2.52) was positively associated with all outcomes. Higher other consultations (RR = 2.13 and 1.94), laboratory (RR = 1.36 and 1.31) and imaging tests (RR = 1.50 and 1.42) were found in teachers with musculoskeletal pain and health insurance. Those with common mental disorders presented higher use of medical (RR = 1.50) or other consultations (RR = 1.41), as well as the emergency service (RR = 1.43). Length of employment was positively associated with other consultations (RR = 1.56 to 3.50) and imaging tests (RR = 1.28 to 1.39). Inadequate school infrastructure and musculoskeletal pain were associated with higher medical consultations (RR = 1.46 and 1.51), while problems related to dust and voice disorders were associated with higher use of the emergency service (RR = 1.60 to 1.99). Although the associations varied according to the outcome, the main predictors of health services were the presence of disability, chronic disease, musculoskeletal pain and common mental disorders. These variables should be considered to monitor and promote health care accessibility or reduce costs associated with health service use among elementary teachers.