title: Psychological distress and the decision to seek medical care among a Medicare population.
abstract: Although there have been a number of studies linking psychological distress to the demand for medical care, few studies have examined this relationship among the aged. The issue is important, however, partly because it has been suggested that distress might cause some individuals to seek unneeded medical care. The financial impact of the aged seeking unneeded care on Medicare is, thus, a matter of public concern. This study presents results from a prospective investigation of the impact of psychological distress on the seeking of medical care among a sample of 1,009 Medicare recipients. Following a baseline interview that assessed, among other things, psychological distress, the respondents were reinterviewed six times over the course of one year. Respondents reporting episodes of illness at each interview were asked a series of questions regarding how they responded to the episode. The present analysis examines the impact of a series of variables, including psychological distress, on the decision to seek care for each of the episodes about which the respondent was queried. It also examines the impact of psychological distress on the total number of physician visits requested by the respondent over the study year. Finally, since a panel of 22 geriatricians rated whether or not the episodes reported by the respondents should have resulted in a physician visit, the impact of psychological distress on the medical necessity of the visits made by these respondents is analyzed. The analyses found no relationship between psychological distress and any of these outcomes. Thus, it does not appear that, among these respondents, psychological distress has any impact either on the frequency of physician visits or the medical necessity of visits made for episodes of illness.
authors.affiliation: School of Public Health, University of California, Los Angeles.
authors.forename: E
authors.initials: E
authors.lastname: Berkanovic
authors.forename: M L
authors.initials: ML
authors.lastname: Hurwicz
mesh_terms: D000368:Aged; D003657:Decision Making; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D015141:Los Angeles; D006278:Medicare / Q000706:statistics & numerical data*; D009819:Office Visits / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care; D012044:Regression Analysis; D013315:Stress, Psychological; D014481:United States