title: Underutilization of health services among patients with urinary symptoms: results of a population-based survey in Israel.
abstract: BACKGROUND
  Although there is firm evidence concerning the relatively-high rates of overutilization of prostate surgery among elderly men, only minimal efforts have been made to evaluate the existence and extent of underutilization. This assessment, accomplished by our study, may have a significant impact on health services planning and budgeting.
  
  
  METHODS
  The study population comprised a nationwide representative sample of 960 Israeli men, aged between 45 and 75 years. Data were accumulated by personal interviews conducted at the homes of the individuals by trained staff. The questions included in the questionnaire aimed at describing the sociodemographic and clinical status. The responses to questions regarding male urinary symptoms were obtained by personal reports.
  
  
  RESULTS
  Forty-three percent of the subjects reported having experienced urinary symptoms, but only 4.6% were severely bothered by the symptoms on a daily basis, and 8.9% were moderately bothered. Only 55.4% of patients with bothersome urinary symptoms visited their general practitioners, while only 39.7% were referred to a urologist because of their complaints.
  
  
  CONCLUSIONS
  Elderly men bothered by urinary symptoms frequently do not seek health care. An educational program regarding the potential benefit of medical interventions for benign prostatic hypertrophy may significantly improve their quality of life.
authors.affiliation: Gertner Institute for Health Services Research, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: B
authors.initials: B
authors.lastname: Mozes
authors.forename: A
authors.initials: A
authors.lastname: Shmueli
mesh_terms: D000368:Aged; D006296:Health Services / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D015995:Prevalence; D011468:Prostatectomy / Q000706:statistics & numerical data*; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000453:epidemiology / Q000601:surgery*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology; D016055:Urinary Retention / Q000453:epidemiology / Q000209:etiology; D014555:Urination Disorders / Q000453:epidemiology / Q000209:etiology*