Use of primary health care services according to the different degrees of obesity in the Girona Health Region, Spain.

Our main hypothesis in this paper was that, once controlled for age and gender, the use of primary health care services of people in each of the groups defined by their degree of obesity (i.e. normal weight, overweight and obese) did not correspond to the need for care implied by the level of risk of the group he/she belonged to. This fact could reflect some inequity in the utilisation of such services. Using a survey of the general population from the Girona Health Region, Spain, carried out during the fourth quarter of 2002, we have found that: first, the probability of primary health care use decreased with income for GPs (until 1200 Euro) and increased for specialists (from 1500 Euro). Second, we could conclude by confirming our hypothesis, i.e. there was more probability of obese individuals using general practice care, public in particular, and less probability of them using specialists, private in particular, than the rest of individuals. Third, we conclude that the use of multilevel (also hierarchical or mixed) models could explain most of our original findings in this paper. Copyright 2005 John Wiley & Sons, Ltd.