The Decision to Seek Care: Factors Associated with the Propensity to Seek Care in a Community-Based Cohort of Men

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.