The question of what motivates elders to seek medical advice is explored among a random sample of 467 persons aged 65 and over living in Ohio, USA. The effect of physical and psychological variables on an initial physician visit was analysed for particular bodily changes the subjects had experienced. Unlike the situation in many other utilization studies, these specific complaints could be identified as leading to physician contact in a causal sequence. Multiple regression revealed limited effects of self-assessed health, body awareness, depression and anxiety on the decision to consult a physician, but significant effect of the perceived seriousness of the complaint. The findings cast doubt on the utility of self-assessed health and psychological distress as predictors of physician use in major archival studies. This research is unique among utilization studies in that it provides a cross-sectional opportunity to explain a health behavior prospectively in the presence of a specific prior health problem.
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