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Health service utilisation associated with chronic breathlessness: random population sample

Currow, David C.; Chang, Sungwon; Ekström, Magnus; Luckett, Tim; Kochovska, Slavica; Hay, Phillipa; Touyz, Stephen; Dal Grande, Eleonora; Hutchinson, Ann; Johnson, Miriam J.


David C. Currow

Sungwon Chang

Magnus Ekström

Tim Luckett

Slavica Kochovska

Phillipa Hay

Stephen Touyz

Eleonora Dal Grande


Background Most health service utilisation studies are of people with specific diagnoses or demographic characteristics, and rarely of specific chronic symptoms. The aim of this study was to establish whether population-level health service utilisation increases in people with chronic breathlessness. Methods A cross-sectional analysis was carried out of the South Australian Health Omnibus Survey 2017, a multi-stage, clustered area, systematic sampling survey of adults where questions are administered faceto-face in respondents’ homes. Self-report of health service utilisation in the previous 3 months (medical consultations, emergency department, hospital admission), chronic breathlessness (severity, duration, modified Medical Research Council (mMRC) breathlessness scale) and demographic data were used to predict self-reported health service utilisation. Results A total of 2898 people were included (49.0% male; median age 48.0 years (IQR 32.0-63.0); 64.1% educated beyond school; 55.4% in work; 73.5% had outpatient contact; 6.3% had a hospital admission in the previous 3 months). Chronic breathlessness (mMRC ≥1) was reported by 8.8% of respondents. In bivariable analyses, people with greater contact with health services were older, and a higher proportion were overweight/obese and had more severe chronic breathlessness. In multivariable analyses, chronic breathlessness and older age were positively associated with outpatient care and inpatient care, and people with chronic breathlessness were hospitalised for longer (incidence rate ratio 2.5; 95% CI 1.4-4.5). Conclusion There is a significant association between worse chronic breathlessness and increased health service utilisation. There is a need for greater understanding of factors that initiate contact with health services.


Currow, D. C., Chang, S., Ekström, M., Luckett, T., Kochovska, S., Hay, P., …Johnson, M. J. (2021). Health service utilisation associated with chronic breathlessness: random population sample. ERJ Open Research, 7(4), Article 00415-2021.

Journal Article Type Article
Acceptance Date Aug 4, 2021
Online Publication Date Oct 11, 2021
Publication Date Oct 1, 2021
Deposit Date Oct 20, 2021
Publicly Available Date Feb 14, 2022
Journal ERJ Open Research
Electronic ISSN 2312-0541
Publisher European Respiratory Society
Peer Reviewed Peer Reviewed
Volume 7
Issue 4
Article Number 00415-2021
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Copyright ©The authors 2021<br /> This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact

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