title: Differences in care-seeking behavior for acute chest pain in the United States and Japan.
abstract: BACKGROUND
  Delay from onset of acute myocardial infarction symptoms to the delivery of medical care is a major determinant of prognosis. Although studies have explored patient factors for delay in seeking care, there are limited data on international differences in care-seeking behavior.
  
  
  METHODS
  We surveyed 1032 people in the United States and 1422 people in Japan in January 1997 on decision-making responses to a chest pain scenario representing acute MI. Participants were asked about how they would seek initial care and how promptly they would seek care.
  
  
  RESULTS
  The mean age was 43.6 years in the United States and 48.3 years in Japan. For the hypothetical scenario, US respondents were more likely to seek care at an emergency department (22.9% vs 16.2% in Japan) or through emergency medical services/911 (55.9% vs 32.9% in Japan, P =.001). American subjects were also more likely to seek care immediately (83.1% vs 56.4% in Japan, P =.001).
  
  
  CONCLUSIONS
  Respondents in the United States and Japan differed substantially in their responses to a hypothetical chest pain scenario. Whether these differences result from cultural or health care system factors and whether these apparent attitudes produce gaps in real responses to acute coronary syndromes must be explored in further studies.
authors.affiliation: Duke University Medical Center, Durham, NC USA.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Liao
authors.forename: David J
authors.initials: DJ
authors.lastname: Whellan
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Tabuchi
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Schulman
mesh_terms: D000328:Adult; D002637:Chest Pain; D003431:Cross-Cultural Comparison; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D013997:Time Factors; D014481:United States