Skepticism Toward Medical Care and Health Care Utilization

Kevin Fiscella, Peter Franks, Carolyn M. Clancy

Research output: Contribution to journalArticle

120 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)180-189
Number of pages10
JournalMedical Care
Volume36
Issue number2
StatePublished - Feb 1998
Externally publishedYes

Fingerprint

Patient Acceptance of Health Care
medical care
utilization
health care
Physicians
Health Expenditures
Delivery of Health Care
Health Behavior
Health Insurance
physician
Hospital Emergency Service
Hospitalization
expenditures
Preventive Health Services
Papanicolaou Test
health behavior
hospitalization
Aptitude
Social Responsibility
Health Education

Keywords

  • Attitude to health
  • Health behavior
  • Health services

ASJC Scopus subject areas

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

Cite this

Fiscella, K., Franks, P., & Clancy, C. M. (1998). Skepticism Toward Medical Care and Health Care Utilization. Medical Care, 36(2), 180-189.

Skepticism Toward Medical Care and Health Care Utilization. / Fiscella, Kevin; Franks, Peter; Clancy, Carolyn M.

In: Medical Care, Vol. 36, No. 2, 02.1998, p. 180-189.

Research output: Contribution to journalArticle

Fiscella, K, Franks, P & Clancy, CM 1998, 'Skepticism Toward Medical Care and Health Care Utilization', Medical Care, vol. 36, no. 2, pp. 180-189.
Fiscella, Kevin ; Franks, Peter ; Clancy, Carolyn M. / Skepticism Toward Medical Care and Health Care Utilization. In: Medical Care. 1998 ; Vol. 36, No. 2. pp. 180-189.
@article{1a09de79ec424ba3ac351a943061545a,
title = "Skepticism Toward Medical Care and Health Care Utilization",
abstract = "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.",
keywords = "Attitude to health, Health behavior, Health services",
author = "Kevin Fiscella and Peter Franks and Clancy, {Carolyn M.}",
year = "1998",
month = "2",
language = "English (US)",
volume = "36",
pages = "180--189",
journal = "Medical Care",
issn = "0025-7079",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Skepticism Toward Medical Care and Health Care Utilization

AU - Fiscella, Kevin

AU - Franks, Peter

AU - Clancy, Carolyn M.

PY - 1998/2

Y1 - 1998/2

N2 - 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.

AB - 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.

KW - Attitude to health

KW - Health behavior

KW - Health services

UR - http://www.scopus.com/inward/record.url?scp=0031992358&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031992358&partnerID=8YFLogxK

M3 - Article

C2 - 9475472

AN - SCOPUS:0031992358

VL - 36

SP - 180

EP - 189

JO - Medical Care

JF - Medical Care

SN - 0025-7079

IS - 2

ER -