Ristvedt Stephen, Trinkaus Kathryn, Waters Erika, James Aimee
Department of Anesthesiology, Washington University School of Medicine, USA.
Department of Surgery, Washington University School of Medicine, USA.
Heliyon. 2019 May 30;5(5):e01685. doi: 10.1016/j.heliyon.2019.e01685. eCollection 2019 May.
A significant proportion of American adults do not have a regular source of healthcare and the reasons for this shortfall are not fully understood. The objective of this study was to examine the relationship between individual differences in threat sensitivity and healthcare utilization in a survey of 483 African American men. Demographics, psychological characteristics, and health behaviors were assessed. The primary outcomes were: 1) most frequent source of healthcare utilization (doctor's office or clinic vs. emergency room vs. no place), and 2) frequency of healthcare utilization (one or more vs. no healthcare visits in the previous year). Data were analyzed with multivariable logistic regression. Results showed that threat sensitivity, insurance status, and age were associated with the most frequent source of healthcare utilization. Compared to men who most commonly used a doctor's office or clinic, men who tended to use an emergency room had higher levels of threat sensitivity and those with no usual healthcare source had lower levels of threat sensitivity. These findings fit with leading neurobiological theories of personality regarding threat sensitivity. From a pragmatic standpoint, these findings may also lend insight to the tailoring of health marketing messages designed to optimize utilization of healthcare resources.
相当一部分美国成年人没有固定的医疗保健来源,而造成这种不足的原因尚未完全明了。本研究的目的是在一项对483名非裔美国男性的调查中,考察威胁敏感性的个体差异与医疗保健利用之间的关系。评估了人口统计学特征、心理特征和健康行为。主要结果为:1)医疗保健利用的最常见来源(医生办公室或诊所、急诊室、无固定场所),以及2)医疗保健利用的频率(上一年有一次或多次医疗就诊与无医疗就诊)。采用多变量逻辑回归分析数据。结果显示,威胁敏感性、保险状况和年龄与医疗保健利用的最常见来源相关。与最常使用医生办公室或诊所的男性相比,倾向于使用急诊室的男性威胁敏感性水平更高,而没有固定医疗保健来源的男性威胁敏感性水平更低。这些发现与关于威胁敏感性的主要人格神经生物学理论相符。从实际角度来看,这些发现也可能为优化医疗资源利用的健康营销信息的定制提供见解。