A population-based study of health care-seeking behavior for treatment of urinary symptoms. The Olmsted County Study of Urinary Symptoms and Health Status Among Men
S. J. Jacobsen, H. A. Guess, L. Panser, C. J. Girman, C. G. Chute, J. E. Oesterling and M. M. Lieber
Section of Clinical Epidemiology, Mayo Clinic and Foundation, Rochester, Minn.
OBJECTIVE: To determine the extent to which severity of urinary symptoms
predicts a man's decision to seek medical care for urinary symptoms.
DESIGN: Cross-sectional, population-based survey; the baseline component of
a prospective cohort study. SETTING: Olmsted County, Minnesota (1990
population, 105,720), including the city of Rochester (population, 69,995)
and surrounding rural townships. SUBJECTS: A population-based sample of men
aged 40 to 79 years randomly selected within age- and residence-specific
strata. INTERVENTION: A previously validated questionnaire that elicited
information about the frequency and bother of urinary symptoms,
sociodemographic information, and information regarding use of physician
services in the last year. MAIN OUTCOME MEASURE: An affirmative response to
any of 12 questions asking the subject if he had seen a physician in the
last year because of specific urinary symptoms. MAIN RESULT: Symptom
severity, whether measured by American Urologic Association frequency or
bother score or by interference with daily activities, was a significant
predictor of health care-seeking behavior for urinary symptoms, but was
neither as sensitive nor as specific as would be ideal. After adjusting for
symptom severity and sociodemographic characteristics, men aged 70 to 79
years were 4.6 times as likely (95% confidence interval, 2.1 to 10.1) as
men aged 40 to 49 years to have sought health care because of urinary
symptoms in the last year. CONCLUSION: While symptom severity is an
important determinant of health care-seeking behavior for men with urinary
symptoms, some additional factor or factors associated with age remain that
may drive men to seek care for urinary symptoms. These factors may prove
important in understanding the small-area variations in treatment of benign
prostatic hyperplasia that have been noted by others.
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