title: Health care seeking behavior and perceptions of the medical profession among pre- and post-retirement age Dutch dancers.
abstract: A cross-sectional, descriptive survey and a medical chart review of 154 pre- and post-retirement age injured Dutch dancers were performed. The purpose was to examine dancers' health care seeking behavior and perceptions of the medical profession in context of the current health care system in The Netherlands, which includes both universal access and expertise in performing arts medicine. No logistical or perceptual restrictions to health care were reported by the dancers in this study. Only three younger dancers (< 35 years) lacked a primary care physician. No dancer reported monetary or insurance hindrances to acquiring an appointment or fear of going to the doctor. A small percentage of the younger group (18%), but none of the older dancers, reported that they felt the doctor would not understand them (chi(2) = 2.2, df = 1, p = 0.14). Dancers in both age groups most often sought first treatment from either a physiotherapist (36% to 40%) or a medical doctor (38.8% to 40.8%). When a physician was not consulted first, the primary reason was that dancers had already seen a physiotherapist and thought this treatment was sufficient. Approximately one-third of dancers expected their medical problem to go away on its own. Dutch dancers were additionally found to have a positive relationship with the medical profession, including high satisfaction and confidence. The majority of dancers were satisfied or very satisfied with their medical treatment prior to presenting to the dance medicine specialist (67% older dancers, 52% younger, chi(2) = 1.19, df = 1, p = 0.2). Nearly every dancer was satisfied or very satisfied after treatment by the specialist (100% older dancers, 93% younger dancers, chi(2) = 1.46, df = 1, p = 0.2), and moderately or completely confident of full recovery (80%, each group). Differences in older and younger dancers' perceptions and behaviors were nevertheless found. Older dancers were significantly more likely to continue to dance when injured than younger dancers (100% versus 82%, chi(2) = 5.14, df = 1, p = 0.02), although pain and perceived level of artistic hindrance were similar between the groups at first presentation to a dance medicine clinic (pain: 32.6 versus 34.0 mm, respectively, p = 0.83; artistic hindrance: 49.3 versus 58.0 mm, p = 0.29, respectively). Older dancers were more likely to wait and see for themselves whether an injury would get better by itself (14% versus 4%, chi(2) = 4.1, df = 1, p = 0.05). Average time to seek treatment from a medical doctor was four times longer among older than younger dancers (8.4 versus 2.1 months, respectively, p = 0.004), and older dancers had less confidence in full recovery at first visit (40% versus 61%, chi(2) = 3.8, df = 1, p = 0.05). Thus, the medical system of The Netherlands is one that confers improved health care access and perceptions of the medical profession among dancers, yet there remain areas to be addressed in terms of equalization of health care delivery.
authors.affiliation: Yale University School of Medicine, New Haven, Connecticut, USA. mamie.air@yale.edu
authors.forename: Mamie
authors.initials: M
authors.lastname: Air
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D003430:Cross-Sectional Studies; D003615:Dancing / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data; D012938:Social Perception; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000453:epidemiology / Q000534:rehabilitation*