Health care utilization by older adults in response to painful orofacial symptoms

The purpose of this study was to determine which specific attributes of pai nful orofacial symptoms serve as predictors of health care utilization in a population based sample of elderly subjects. Furthermore, we documented pa tterns of health care utilization selection by type of health care provider . To our knowledge, these specific utilization patterns have never before b een reported in the pain literature. Telephone interviews were conducted wi th a stratified random sample of 1636 community dwelling older (65+) north Floridians. A total of 5860 households were contacted and screened, with 75 .3% participating to the point where their eligibility for the study could be determined. The percentage of subjects reporting health care utilization for a specific symptom ranged from 62 to 32%. One or more health care visi ts were reported by at least 50% of those reporting symptoms of toothache p ain, facial pain, jaw joint pain and burning mouth in the past 12 months. T hese rates suggest that elderly individuals are willing and able to seek he alth care for painful orofacial symptoms. We found that pain intensity was the best predictor of whether an elderly individual utilized health care or not, which suggests that some pain intensity threshold may exist at which health care seeking behavior is initialed. The overall number of visits was not predicted by pain intensity but by other qualities more associated wit h time or level of dysfunction caused by the symptom. We also found that el derly adults, typically seek care for toothache from a dentist and from phy sicians for painful orofacial symptoms not associated with the teeth of mou th. These decisions regarding the selection of a health care professional m ay, in part, be a function of financial and insurance considerations, anato mical site and perception of the role of dentistry in orofacial care. (C) 1 999 International Association for the Study of Pain. Published by Elsevier Science B.V.