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Use of physician services following participation in a cardiac screening program
Insights
Cardiac screening effectiveness is limited when patients with abnormal results don't seek treatment or when those with normal results overuse medical services due to persistent heart disease concerns. Patient factors significantly influence follow-up care utilization.
Area of Science:
- Cardiology
- Preventive Medicine
- Health Services Research
Background:
- Cardiac screening programs aim to detect heart disease early.
- Program effectiveness hinges on appropriate patient follow-up and resource utilization.
- Patient adherence to recommended treatment and avoidance of unnecessary care are critical.
Purpose of the Study:
- To identify factors predicting physician service use post-cardiac screening.
- To understand predictors of follow-up care for abnormal screening results.
- To assess the impact of patient concerns on healthcare seeking behavior.
Main Methods:
- Retrospective analysis of cardiac screening participants.
- Logistic regression models used to predict physician service use.
- Predictors included age, sex, cardiac symptom concern, life stress, and test results.
Main Results:
- Abnormal test results, older age, life stress, and cardiac concern predicted physician use.
- Older age, male sex, and cardiac concern predicted abnormal test results.
- High patient concern, even with normal findings, led to similar physician visits as abnormal findings with low concern.
Conclusions:
- Cardiac screening follow-up is influenced by both clinical findings and patient-reported factors like concern and stress.
- Patient anxiety and concern significantly impact healthcare seeking behavior, irrespective of objective findings.
- Interventions focusing solely on symptom concern did not improve follow-up rates for abnormal screening outcomes.
Abstract:
Cardiac screening programs are ineffective when participants with abnormal findings fail to seek treatment and, to a lesser extent, when participants with normal findings use medical facilities unnecessarily because of continuing concern about heart disease. Age, sex, measure of concern about cardiac symptoms and life stress, and abnormal test results were used to predict the use of physician services in the 3 months following screening. Abnormal test results predicted the use of physician services after screening, as did being older, and having life stress and concern about cardiac symptoms. Being older, male, and concerned about cardiac symptoms predicted having at least one abnormal test result. Participants with normal findings and high levels of concern about cardiac symptoms were as likely to see a physician after the screening as were persons with abnormal findings and low levels of concern about cardiac symptoms. Emphasizing participants' concern about symptoms of heart disease or feelings of stress failed to produce an increase in followup for persons who had abnormal screening outcomes.