Roberts R O, Rhodes T, Girman C J, Guess H A, Oesterling J E, Lieber M M, Jacobsen S J
Section of Clinical Epidemiology, Mayo Clinic and Foundation, Rochester, MN, USA.
Arch Fam Med. 1997 May-Jun;6(3):218-22. doi: 10.1001/archfami.6.3.218.
To investigate factors associated with a high propensity to seek care.
Cross-sectional baseline component of a prospective cohort study.
Olmsted County, Minnesota.
A randomly selected, community-based cohort of 2115 men aged 40 to 79 years on January 1, 1990.
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.
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.
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.
调查与高就医倾向相关的因素。
前瞻性队列研究的横断面基线部分。
明尼苏达州奥尔姆斯特德县。
1990年1月1日随机选取的2115名年龄在40至79岁之间的社区男性队列。
参与者完成一份问卷，该问卷通过7个关于身体疾病的假设情景来获取有关就医倾向的信息。还询问了前一年自我报告的门诊医生就诊情况和社会人口统计学因素。
就医倾向与医生就诊率之间存在显著关联。就医倾向高的男性更有可能就诊4次或更多次（比值比[OR]，1.7；95%置信区间[CI]，1.3 - 2.3）。双变量分析表明，因身体原因就医的倾向与退休（OR，2.0；95% CI，1.1 - 2.6）、65岁及以上年龄（OR，1.9；95% CI，1.5 - 2.4）、高中未毕业（OR，1.6；95% CI，1.1 - 2.2）以及年收入低于25,000美元（OR，1.4；95% CI，1.1 - 1.9）之间存在显著关联。多变量逻辑回归分析表明，退休男性更有可能有高就医倾向（OR，1.7；95% CI，1.2 - 2.4），其他变量不再具有显著性。
我们的研究结果表明就医倾向与医生就诊率及退休之间存在关联。鉴于美国老年人数量不断增加，退休男性相对较高的就医倾向对老年人医疗保健成本的影响可能比人们普遍认识到的更大。
