رابطه بین رضایت از زندگی و استفاده از مراقبت های بهداشتی: یک مطالعه طولی The Relationship Between Life Satisfaction and Healthcare Utilization: A Longitudinal Study

NTRODUCTION Life satisfaction is a reliable dimension of quality of life, encompassing physical, mental, and social well-being.1 Recent studies have highlighted the importance of life satisfaction, or more generally, happiness, on health.2 The majority of research has been primarily focused on the mental health aspects of life satisfaction, but there is recent evidence suggesting that the health impacts of life satisfaction may be more widespread.3 A number of studies have emphasized the impact that life satisfaction has on healthy behaviors, risk of chronic disease, longevity, and a proactive approach to maintaining a healthy lifestyle.4,5 However, there are few population-based studies that have prospectively assessed the relationship between measures of life satisfaction and the impact on the healthcare system. The lack of literature in this area results from a paucity of population-based data that links both information on life satisfaction and healthcare utilization in a longitudinal manner. The relationship between health behaviors, chronic illness, and life satisfaction is likely bidirectional. Chronic illness and health-related risk factors have been demonstrated to have an independent association with life dissatisfaction, whereas optimism, life satisfaction, and social inclusion have revealed their protective properties in health respectively.6 People who are happy and satisfied with their life exhibit better self-rated health, absence of chronic and life-limiting conditions, as well as higher engagement with physical activity programs.7 Enrichment of life satisfaction through the use of psychological intervention has proven meaningful to enhancing subjective and psychological well-being.8,9 These factors may go on to affect the frequency of healthcare utilization and the necessity of healthcare services for existing disease management. In healthcare systems worldwide, high-cost users (HCUs) disproportionately account for a majority of healthcare spending costs.10–12 Previous research has identified important upstream determinants, as well as the impact that multimorbidity has on high healthcare utilization.13,14 In order to improve the sustainability of the healthcare system, an in-depth understanding of all risk factors and social characteristics that perpetuate concentrated healthcare spending in a small fraction of the population is necessary. Importantly, per-person healthcare costs reflect the combination of frequency, intensity, and complexity of healthcare utilization and thus are a meaningful and important metric of healthcare utilization. The goal of this study is to investigate the impact of life satisfaction on patterns of future healthcare utilization by linking multiple cycles of a national population-based survey to subsequent health services utilization data from a single-payer system in Ontario, Canada.