Skepticism Toward Medical Care and Health Care Utilization

Dados Bibliográficos

ID9100367
AutoresKevin Fiscella (0000-0003-3613-8012, The Family Center, autor correspondente), Peter Franks (0000-0002-9782-0181, autor correspondente), Carolyn M Clancy (0000-0002-0308-5535)
Ano1998
Volume36
Fascículo2
Páginas180-189
Data de publicação1998-02-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoMedical Care (JOURNAL)
Identificadores do periódicoISSN: 0025-7079 • E-ISSN: 1537-1948
EditoraOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-199802000-00007
PMID9475472
OpenAlexW1967438044
IdiomaEN
Citações recebidas37
Referências citadas25

OBJECTIVES: As health care moves toward systems that assume accountability for defined populations, there has been increasing emphasis on developing performance measures for those systems and their providers, with little attention given to patient demand or attitudinal factors. The impact of skepticism toward health care providers on health behavior and health care utilization was assessed using a cross-sectional analysis of data from the 1987 National Medical Expenditure Survey (NMES). METHODS: A nationally representative sample from the United States comprising 18,240 persons 25 years and older was surveyed. Skepticism, defined as doubts about the ability of conventional medical care to appreciably alter one's health status, was assessed through a 4-item scale. Outcome measures included health behavior, access (health care insurance, having a regular source of care, and physician type), utilization (annual number of physician or emergency department visits and hospitalizations), total annual health care expenditures, and preventive health care behavior (having had a Pap smear within 3 years or ever having had a mammogram). RESULTS: In multivariate analyses, skepticism was associated with younger age, white race, lower income, less education, and higher health perceptions. After adjusting for these variables, skepticism was associated with less healthy behavior, with not having health insurance, not having one's own physician, choice of a physician, fewer physician and emergency department visits, less frequent hospitalizations, lower annual health care expenditures, and less prevention compliance. CONCLUSIONS: Medical skepticism represents a relevant patient demand factor that demonstrates significant associations with a variety of health care access and utilization measures with important policy implications

Emergency department · Family medicine · Health care · Health Information National Trends Survey · Multivariate analysis · Skepticism · Health Systems, Economic Evaluations, Quality of Life · Healthcare Policy and Management · Medication Adherence and Compliance · Medicine · Nursing