title: Risk-Taking Attitudes of Patients who Seek Health Care: An Exploratory Approach through Lottery Games.
abstract: BACKGROUND
  The characterization of the risk-taking attitude of individuals may be useful for planning health care interventions. It has been attempted to study expressions of risk-taking attitude and evaluate characteristics of a standard lottery game in a population that seeks health care to elicit these attitudes.
  
  
  METHODS
  Multicentric cross-sectional study. Demographic and socioeconomic characteristics, quality of life (EuroQol-5D), and health risk behaviors were collected from 662 users of 23 health centers selected by random sampling. Risk-taking attitude was evaluated by means of a self-evaluation scale and two lottery games, (L1 and L2; L2 included the possibility of economic losses). Generalized estimating equations (GEE) explicative models were used to evaluate the variability of risk-taking attitude.
  
  
  RESULTS
  Nineteen percent out of interviewed people (CI95%: 15.6-22.6%) expressed a high risk appetite, but only 10.0% (CI95% 7.0 to 13.0) were classified as risk-seeking by L2. It was found association between increased risk appetite and having a better perception of health status (0.110, CI95%: 0,007-0,212) or a higher income (0.010, CI95%: 0.017- 0.123) or smoking status (0.059, CI95%: 0.004- 0.114). Being Spanish was associated with lower risk appetite (-0.105, CI95%: -0.005 --0.205), as being over 65 (-0.031, CI95%:- 0.061- -0.001) or a woman (-0.038, CI95%:-0.064- -0.012). The intraclass correlation coefficient for self-evaluation scale was 0.511 (95% CI: 0.372 to 0.629), 0.571 (95% CI: 0.441 to 0.678) for L1 and 0.349 (95% CI: 0.186-0.493) to L2.
  
  
  CONCLUSIONS
  People who seek health care express certain inclination to risk, but this feature is attenuated when methodologies involving losses are used. Risk appetite seems greater in young people, males, people with better health, or more income, and in immigrants. Lottery games such as the proposed ones are a simple and useful tool to estimate individuals' inclination to risk.
authors.affiliation: Consultorio de Villamanta. Gerencia de Atención Primaria. Servicio Madrileño de Salud and Facultad de Ciencias de la Salud. Universidad Rey Juan Carlos, Madrid and Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)jmfernandez@salud.madrid.org.
authors.forename: Jesús
authors.initials: J
authors.lastname: Martín-Fernández
authors.affiliation: Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)and Unidad Docente de Atención Familiar y Comunitaria Oeste. Gerencia de Atención Primaria. Servicio Madrileño de Salud.
authors.forename: Gloria
authors.initials: G
authors.lastname: Ariza-Cardiel
authors.affiliation: Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)and Unidad Docente de Atención Familiar y Comunitaria Norte. Gerencia de Atención Primaria. Servicio Madrileño de Salud.
authors.forename: Elena
authors.initials: E
authors.lastname: Polentinos-Castro
authors.affiliation: Departamento de Dirección y Organización de Empresas. Escuela de Ingeniería y Arquitectura. Universidad de Zaragoza.
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Gil-Lacruz
authors.affiliation: FIIBAP, Consejería de Sanidad Madrid and Facultad de Medicina, Universidad Complutense de Madrid and Instituto de Investigación i + 12 Hospital 12 de Octubre.
authors.forename: Tomás
authors.initials: T
authors.lastname: Gómez-Gascón
authors.affiliation: Servicio Promoción de Salud Subdirección Gral. de Promoción, Prevención y Educación para la Salud. Dirección General de Salud Pública. Madrid.
authors.forename: Julia
authors.initials: J
authors.lastname: Domínguez-Bidagor
authors.affiliation: Unidad de Apoyo a la Investigación. Gerencia de Atención Primaria. Servicio Madrileño de Salud.
authors.forename: Isabel
authors.initials: I
authors.lastname: Del-Cura-González
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D059026:Diagnostic Self Evaluation; D054242:Emigrants and Immigrants; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012306:Risk; D012309:Risk-Taking; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology
keywords: Alcohol Drinking; Choice Behaviour; Games, experimental; Immigrants; Models, Theoretical; Primary Health Care; Risk-taking; Spain; Tobacco Use