title: Health care utilization by older adults in response to painful orofacial symptoms.
abstract: The purpose of this study was to determine which specific attributes of painful orofacial symptoms serve as predictors of health care utilization in a population based sample of elderly subjects. Furthermore, we documented patterns of health care utilization selection by type of health care provider. To our knowledge, these specific utilization patterns have never before been reported in the pain literature. Telephone interviews were conducted with a stratified random sample of 1636 community dwelling older (65+) north Floridians. A total of 5860 households were contacted and screened, with 75.3% participating to the point where their eligibility for the study could be determined. The percentage of subjects reporting health care utilization for a specific symptom ranged from 62 to 32%. One or more health care visits were reported by at least 50% of those reporting symptoms of toothache pain, facial pain, jaw joint pain and burning mouth in the past 12 months. These rates suggest that elderly individuals are willing and able to seek health care for painful orofacial symptoms. We found that pain intensity was the best predictor of whether an elderly individual utilized health care or not, which suggests that some pain intensity threshold may exist at which health care seeking behavior is initiated. The overall number of visits was not predicted by pain intensity but by other qualities more associated with time or level of dysfunction caused by the symptom. We also found that elderly adults, typically seek care for toothache from a dentist and from physicians for painful orofacial symptoms not associated with the teeth or mouth. These decisions regarding the selection of a health care professional may, in part, be a function of financial and insurance considerations, anatomical site and perception of the role of dentistry in orofacial care.
authors.affiliation: Claude Pepper Center for Research of Oral Health in Aging, College of Dentistry, University of Florida, Gainesville, USA. jriley3@ufl.edu
authors.forename: J L
authors.initials: JL
authors.lastname: Riley
authors.forename: G H
authors.initials: GH
authors.lastname: Gilbert
authors.forename: M W
authors.initials: MW
authors.lastname: Heft
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D003729:Dental Care / Q000706:statistics & numerical data; D005157:Facial Pain / Q000503:physiopathology / Q000628:therapy*; D005544:Forecasting; D006282:Health Personnel / Q000706:statistics & numerical data; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007568:Jaw; D007592:Joint Diseases / Q000503:physiopathology / Q000628:therapy; D009059:Mouth Diseases / Q000503:physiopathology / Q000628:therapy*; D009819:Office Visits; D010146:Pain / Q000503:physiopathology; D059408:Pain Management; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D014098:Toothache / Q000503:physiopathology / Q000628:therapy