A population-based study of health care-seeking behavior for treatment of urinary symptoms. The Olmsted County Study of Urinary Symptoms and Health Status Among Men

Abstract

Objective: To determine the extent to which severity of urinary symptoms predicts a man's decision to seek medical care for urinary symptoms.

Design: Cross-sectional, population-based survey; the baseline component of a prospective cohort study.

Setting: Olmsted County, Minnesota (1990 population, 105,720), including the city of Rochester (population, 69,995) and surrounding rural townships.

Subjects: A population-based sample of men aged 40 to 79 years randomly selected within age- and residence-specific strata.

Intervention: A previously validated questionnaire that elicited information about the frequency and bother of urinary symptoms, sociodemographic information, and information regarding use of physician services in the last year.

Main outcome measure: An affirmative response to any of 12 questions asking the subject if he had seen a physician in the last year because of specific urinary symptoms.

Main result: Symptom severity, whether measured by American Urologic Association frequency or bother score or by interference with daily activities, was a significant predictor of health care-seeking behavior for urinary symptoms, but was neither as sensitive nor as specific as would be ideal. After adjusting for symptom severity and sociodemographic characteristics, men aged 70 to 79 years were 4.6 times as likely (95% confidence interval, 2.1 to 10.1) as men aged 40 to 49 years to have sought health care because of urinary symptoms in the last year.

Conclusion: While symptom severity is an important determinant of health care-seeking behavior for men with urinary symptoms, some additional factor or factors associated with age remain that may drive men to seek care for urinary symptoms. These factors may prove important in understanding the small-area variations in treatment of benign prostatic hyperplasia that have been noted by others.