Primary and Emergency Care Use: The Roles of Health Literacy, Patient Activation, and Sleep Quality in a Latent Profile Analysis
Background/Objectives: Healthcare utilization is a behavioral phenomenon influenced by psychosocial factors. This study took place in South Tyrol, a culturally diverse autonomous province in northern Italy, and aimed to identify latent profiles of primary healthcare users based on health literacy, p...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-05-01
|
| Series: | Behavioral Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-328X/15/6/724 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850156657619763200 |
|---|---|
| author | Dietmar Ausserhofer Verena Barbieri Stefano Lombardo Timon Gärtner Klaus Eisendle Giuliano Piccoliori Adolf Engl Christian J. Wiedermann |
| author_facet | Dietmar Ausserhofer Verena Barbieri Stefano Lombardo Timon Gärtner Klaus Eisendle Giuliano Piccoliori Adolf Engl Christian J. Wiedermann |
| author_sort | Dietmar Ausserhofer |
| collection | DOAJ |
| description | Background/Objectives: Healthcare utilization is a behavioral phenomenon influenced by psychosocial factors. This study took place in South Tyrol, a culturally diverse autonomous province in northern Italy, and aimed to identify latent profiles of primary healthcare users based on health literacy, patient activation, sleep quality, and service use, and to examine the sociodemographic and health-related predictors of profile membership. Methods: A cross-sectional survey was conducted with a representative adult sample (<i>n</i> = 2090). The participants completed the questionnaire in German or Italian. Latent profiles were identified via model-based clustering using Gaussian mixture modeling and four z-standardized indicators: total primary healthcare contacts (general practice and emergency room visits), HLS-EU-Q16 (health literacy), PAM-10 (patient activation), and B-PSQI (sleep quality). The optimal cluster solution was selected using the Bayesian Information Criterion (BIC). Kruskal–Wallis and chi-square tests were used for between-cluster comparisons of the data. Multinomial logistic regression was used to examine the predictors of cluster membership. Results: Among the 1645 respondents with complete data, a three-cluster solution showed a good model fit (BIC = 19,518; silhouette = 0.130). The identified profiles included ‘Balanced Self-Regulators’ (72.8%), ‘Struggling Navigators’ (25.8%), and ‘Hyper-Engaged Users’ (1.4%). Sleep quality could be used to differentiate between different levels of service use (<i>p</i> < 0.001), while low health literacy and patient activation were key features of the high-utilization groups. Poor sleep and inadequate health literacy were associated with increased healthcare contact. Conclusions: The latent profiling revealed distinct patterns in health care engagement. Behavioral segmentation can inform more tailored and culturally sensitive public health interventions in diverse settings such as South Tyrol. |
| format | Article |
| id | doaj-art-e9d77da4af854240873e38c71ad1b9f2 |
| institution | OA Journals |
| issn | 2076-328X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Behavioral Sciences |
| spelling | doaj-art-e9d77da4af854240873e38c71ad1b9f22025-08-20T02:24:26ZengMDPI AGBehavioral Sciences2076-328X2025-05-0115672410.3390/bs15060724Primary and Emergency Care Use: The Roles of Health Literacy, Patient Activation, and Sleep Quality in a Latent Profile AnalysisDietmar Ausserhofer0Verena Barbieri1Stefano Lombardo2Timon Gärtner3Klaus Eisendle4Giuliano Piccoliori5Adolf Engl6Christian J. Wiedermann7Institute of General Practice and Public Health, Claudiana—College of Health Professions, 39100 Bolzano, ItalyInstitute of General Practice and Public Health, Claudiana—College of Health Professions, 39100 Bolzano, ItalyProvincial Institute for Statistics of the Autonomous Province of Bolzano—South Tyrol (ASTAT), 39100 Bolzano, ItalyProvincial Institute for Statistics of the Autonomous Province of Bolzano—South Tyrol (ASTAT), 39100 Bolzano, ItalyDirectorate, Claudiana—College of Health Professions, 39100 Bolzano, ItalyInstitute of General Practice and Public Health, Claudiana—College of Health Professions, 39100 Bolzano, ItalyInstitute of General Practice and Public Health, Claudiana—College of Health Professions, 39100 Bolzano, ItalyInstitute of General Practice and Public Health, Claudiana—College of Health Professions, 39100 Bolzano, ItalyBackground/Objectives: Healthcare utilization is a behavioral phenomenon influenced by psychosocial factors. This study took place in South Tyrol, a culturally diverse autonomous province in northern Italy, and aimed to identify latent profiles of primary healthcare users based on health literacy, patient activation, sleep quality, and service use, and to examine the sociodemographic and health-related predictors of profile membership. Methods: A cross-sectional survey was conducted with a representative adult sample (<i>n</i> = 2090). The participants completed the questionnaire in German or Italian. Latent profiles were identified via model-based clustering using Gaussian mixture modeling and four z-standardized indicators: total primary healthcare contacts (general practice and emergency room visits), HLS-EU-Q16 (health literacy), PAM-10 (patient activation), and B-PSQI (sleep quality). The optimal cluster solution was selected using the Bayesian Information Criterion (BIC). Kruskal–Wallis and chi-square tests were used for between-cluster comparisons of the data. Multinomial logistic regression was used to examine the predictors of cluster membership. Results: Among the 1645 respondents with complete data, a three-cluster solution showed a good model fit (BIC = 19,518; silhouette = 0.130). The identified profiles included ‘Balanced Self-Regulators’ (72.8%), ‘Struggling Navigators’ (25.8%), and ‘Hyper-Engaged Users’ (1.4%). Sleep quality could be used to differentiate between different levels of service use (<i>p</i> < 0.001), while low health literacy and patient activation were key features of the high-utilization groups. Poor sleep and inadequate health literacy were associated with increased healthcare contact. Conclusions: The latent profiling revealed distinct patterns in health care engagement. Behavioral segmentation can inform more tailored and culturally sensitive public health interventions in diverse settings such as South Tyrol.https://www.mdpi.com/2076-328X/15/6/724primary healthcare utilizationlatent profile analysishealth literacypatient activationsleep qualityhealthcare engagement |
| spellingShingle | Dietmar Ausserhofer Verena Barbieri Stefano Lombardo Timon Gärtner Klaus Eisendle Giuliano Piccoliori Adolf Engl Christian J. Wiedermann Primary and Emergency Care Use: The Roles of Health Literacy, Patient Activation, and Sleep Quality in a Latent Profile Analysis Behavioral Sciences primary healthcare utilization latent profile analysis health literacy patient activation sleep quality healthcare engagement |
| title | Primary and Emergency Care Use: The Roles of Health Literacy, Patient Activation, and Sleep Quality in a Latent Profile Analysis |
| title_full | Primary and Emergency Care Use: The Roles of Health Literacy, Patient Activation, and Sleep Quality in a Latent Profile Analysis |
| title_fullStr | Primary and Emergency Care Use: The Roles of Health Literacy, Patient Activation, and Sleep Quality in a Latent Profile Analysis |
| title_full_unstemmed | Primary and Emergency Care Use: The Roles of Health Literacy, Patient Activation, and Sleep Quality in a Latent Profile Analysis |
| title_short | Primary and Emergency Care Use: The Roles of Health Literacy, Patient Activation, and Sleep Quality in a Latent Profile Analysis |
| title_sort | primary and emergency care use the roles of health literacy patient activation and sleep quality in a latent profile analysis |
| topic | primary healthcare utilization latent profile analysis health literacy patient activation sleep quality healthcare engagement |
| url | https://www.mdpi.com/2076-328X/15/6/724 |
| work_keys_str_mv | AT dietmarausserhofer primaryandemergencycareusetherolesofhealthliteracypatientactivationandsleepqualityinalatentprofileanalysis AT verenabarbieri primaryandemergencycareusetherolesofhealthliteracypatientactivationandsleepqualityinalatentprofileanalysis AT stefanolombardo primaryandemergencycareusetherolesofhealthliteracypatientactivationandsleepqualityinalatentprofileanalysis AT timongartner primaryandemergencycareusetherolesofhealthliteracypatientactivationandsleepqualityinalatentprofileanalysis AT klauseisendle primaryandemergencycareusetherolesofhealthliteracypatientactivationandsleepqualityinalatentprofileanalysis AT giulianopiccoliori primaryandemergencycareusetherolesofhealthliteracypatientactivationandsleepqualityinalatentprofileanalysis AT adolfengl primaryandemergencycareusetherolesofhealthliteracypatientactivationandsleepqualityinalatentprofileanalysis AT christianjwiedermann primaryandemergencycareusetherolesofhealthliteracypatientactivationandsleepqualityinalatentprofileanalysis |