Sociodemographics, general health, and psychologic health in uninvestigated dyspepsia: a comparison of public and private patients.
OBJECTIVE
To compare the dyspepsia severity, general health, and psychologic health of patients with uninvestigated dyspepsia presenting in private and public settings.


METHODS
Patients in this cross-sectional study were recruited from the Houston Veterans Administration (VA) General Medicine Outpatient Clinic and from the nearby private practice of a family physician. To be included, patients had to be at least 18 years of age and had to report a history of dyspepsia (epigastric discomfort) without alarm of at least 1 week's duration. Clinical information was obtained. Dyspepsia severity was measured using dyspepsia-related health scales, general health was measured using the Short Form 36, and psychologic health was measured using six scales.


RESULTS
The authors enrolled 159 patients (59 VA). There were no differences in VA and private patients in most of the clinical characteristics related to dyspepsia. Compared with the private patients, the VA patients had worse scores on all Short Form 36 subscales, had lower expectations for treatment outcome, were more depressed, and had less optimism about life.


CONCLUSIONS
Burden of illness and psychologic factors such as patient expectations are known to have important effects on patient outcomes. Striking differences in these factors exist in patients with uninvestigated dyspepsia seen in private and public settings. In the future, these factors must be taken into account both in conducting studies in dyspepsia and in interpreting the results for different practice settings.
Rabeneck
Linda
L
Department of Veterans Affairs, Health Services Research and Development Center of Excellence, Baylor College of Medicine, Houston, TX 77030, U.S.A.
Wristers
Kimberly
K
Campbell
Catherine
C
Souchek
Julianne
J
Menke
Terri
T
Wray
Nelda P
NP
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004415:Dyspepsia / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006304:Health Status; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D011331:Private Practice; D012959:Socioeconomic Factors; D014481:United States