The decision to seek care. Factors associated with the propensity to seek care in a community-based cohort of men
R. O. Roberts, T. Rhodes, C. J. Girman, H. A. Guess, J. E. Oesterling, M. M. Lieber and S. J. Jacobsen
Section of Clinical Epidemiology, Mayo Clinic and Foundation, Rochester, MN, USA.
OBJECTIVE: To investigate factors associated with a high propensity to seek
care. DESIGN: Cross-sectional baseline component of a prospective cohort
study. SETTING: Olmsted County, Minnesota. SUBJECTS: A randomly selected,
community-based cohort of 2115 men aged 40 to 79 years on January 1, 1990.
MEASUREMENTS: Participants completed a questionnaire that elicited
information about the propensity to seek care by means of 7 hypothetical
scenarios about physical illness. Also queried was the self-reported
outpatient physician utilization in the previous year and sociodemographic
factors. RESULTS: There was a significant association between propensity to
seek care and physician utilization. Men with a high propensity to seek
care were more likely to have had 4 or more physician visits (odds ratio
[OR], 1.7; 95% confidence interval [CI], 1.3-2.3). Bivariate analysis
suggested significant associations between a propensity to seek care for
physical reasons and retirement (OR, 2.0; 95% CI, 1.1-2.6), age of 65 years
or more (OR, 1.9; 95% CI, 1.5-2.4), incomplete high school education (OR,
1.6; 95% CI, 1.1-2.2), and an annual income of less than $25,000 (OR, 1.4;
95% CI, 1.1-1.9). Multivariable logistic regression analysis demonstrated
that retired men were more likely to have a high propensity to seek care
(OR, 1.7; 95% CI, 1.2-2.4), with the other variables no longer-being
significant. CONCLUSIONS: Our findings suggest an association between
propensity to seek care and physician utilization and retirement. In view
of the increasing numbers of aged persons in the United States, this
relatively higher propensity to seek health care among retired men may have
a greater impact on the cost of health care for the aged than is fully
appreciated.
