title: Genetic and environmental contributions to healthcare need and utilization: a twin analysis.
abstract: OBJECTIVE
  An exploratory study to examine the genetic and environmental influences on healthcare-seeking behavior for four health conditions (high blood pressure, mental health problems, joint disorders, and hearing problems).
  
  
  METHODS
  Data collected from 3,602 male-male twin pair members of the Vietnam Era Twin (VET) Registry.
  
  
  METHODS
  Varying models for the relationship between genetic and environmental influences on health condition liability and on treatment use were tested in an attempt to explain the relative contributions of additive genetic, common, and unique environmental effects to health condition and treatment use.
  
  
  METHODS
  A mail and telephone survey of general health status was administered in 1987 to VET Registry twins.
  
  
  RESULTS
  Variance component estimates under the best-fitting model for the genetic component ranged from 24 percent to 52 percent for the condition status and from 42 percent to 56 percent for treatment-seeking behavior.
  
  
  CONCLUSIONS
  Utilization models that consider only environmental parameters will leave a large percentage of variability unexplained. Familial patterns have an impact not only on disease susceptibility but also on healthcare utilization, thereby having lifelong implications for social and fiscal constraints placed on the healthcare system. Thus, explanatory models for healthcare utilization behavior should consider the contribution of genetic factors in the decision to seek and use health services.
authors.affiliation: St. Louis University, School of Public Health, MO 63108, USA.
authors.forename: W R
authors.initials: WR
authors.lastname: True
authors.forename: J C
authors.initials: JC
authors.lastname: Romeis
authors.forename: A C
authors.initials: AC
authors.lastname: Heath
authors.forename: L H
authors.initials: LH
authors.lastname: Flick
authors.forename: L
authors.initials: L
authors.lastname: Shaw
authors.forename: S A
authors.initials: SA
authors.lastname: Eisen
authors.forename: J
authors.initials: J
authors.lastname: Goldberg
authors.forename: M J
authors.initials: MJ
authors.lastname: Lyons
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D004200:Diseases in Twins / Q000209:etiology / Q000235:genetics* / Q000628:therapy; D004777:Environment; D006296:Health Services / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006306:Health Surveys; D006311:Hearing Disorders / Q000209:etiology / Q000235:genetics / Q000628:therapy; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000235:genetics / Q000628:therapy; D007592:Joint Diseases / Q000209:etiology / Q000235:genetics / Q000628:therapy; D008297:Male; D001523:Mental Disorders / Q000209:etiology / Q000235:genetics / Q000628:therapy; D008875:Middle Aged; D008957:Models, Genetic; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011336:Probability; D012042:Registries; D011795:Surveys and Questionnaires; D014728:Veterans