title: The impact of physician consultation on care-seeking during acute episodes of coronary heart disease.
abstract: The care-seeking behavior of 262 patients who experienced acute episodes of coronary heart disease (CHD) was analyzed to determine: the incidence and duration of physician consultation; the proportion of total time from acute symptom onset to hospital arrival consumed by medical evaluation; and the impact of medical evaluation on mode and duration of travel to the hospital and  the duration of medical evaluation and administrative procedures in the hospital emergency room. The results of this analysis suggest that physicians and ancillary medical personnel and the patient and lay others are about equally responsible for "delay" in obtaining definitive medical care. Extended medical evaluation was likely to occur when a patient's physician was an internist-cardiologist and the patient was young or without CHD, and a patient had numerous pre-existent chronic diseases. If effective techniques to bring patients under definitive medical care during the first critical hour of acute coronary episodes are to be developed, both lay and medical behavior should receive research attention.
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000628:therapy; D003327:Coronary Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D010820:Physicians / Q000706:statistics & numerical data*; D011654:Pulmonary Edema / Q000628:therapy; D012803:Sick Role; D013997:Time Factors