Does skepticism towards medical care predict mortality?

K. Fiscella, Peter Franks, C. M. Clancy, M. P. Doescher, J. S. Banthin

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

OBJECTIVES: Attitudes towards medical care have a strong effect on utilization and outcomes. However, there has been little attention to the impact on outcomes of doubts about the value of medical care. This study examines the impact of skepticism toward medical care on mortality using data from the 1987 National Medical Expenditure Survey (NMES). METHODS: A nationally representative sample from the United States comprising 18,240 persons (> or = 25 years) were surveyed. Skepticism was measured through an 8-item scale. Mortality at 5-year follow-up was ascertained through the National Death Index. RESULTS: In a proportional hazards survival analysis of 5-year mortality that controlled for age, sex, race, education, income, marital status, morbidity, and health status, skepticism toward medical care independently predicted subsequent mortality. That risk was attenuated after adjustment for health behaviors but not after adjustment for health insurance status. CONCLUSION: Medical skepticism may be a risk factor for early death. That effect may be mediated through higher rates of unhealthy behavior among the medically skeptical. Further studies using more reliable measures are needed.

Original languageEnglish (US)
Pages (from-to)409-414
Number of pages6
JournalMedical Care
Volume37
Issue number4
StatePublished - Apr 1999
Externally publishedYes

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medical care
mortality
Mortality
Health Status
death
Insurance Coverage
Sex Education
Health Behavior
Marital Status
Health Insurance
Survival Analysis
Health Expenditures
health behavior
marital status
health insurance
morbidity
health status
expenditures
utilization
Morbidity

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)

Cite this

Fiscella, K., Franks, P., Clancy, C. M., Doescher, M. P., & Banthin, J. S. (1999). Does skepticism towards medical care predict mortality? Medical Care, 37(4), 409-414.

Does skepticism towards medical care predict mortality? / Fiscella, K.; Franks, Peter; Clancy, C. M.; Doescher, M. P.; Banthin, J. S.

In: Medical Care, Vol. 37, No. 4, 04.1999, p. 409-414.

Research output: Contribution to journalArticle

Fiscella, K, Franks, P, Clancy, CM, Doescher, MP & Banthin, JS 1999, 'Does skepticism towards medical care predict mortality?', Medical Care, vol. 37, no. 4, pp. 409-414.
Fiscella K, Franks P, Clancy CM, Doescher MP, Banthin JS. Does skepticism towards medical care predict mortality? Medical Care. 1999 Apr;37(4):409-414.
Fiscella, K. ; Franks, Peter ; Clancy, C. M. ; Doescher, M. P. ; Banthin, J. S. / Does skepticism towards medical care predict mortality?. In: Medical Care. 1999 ; Vol. 37, No. 4. pp. 409-414.
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