Structural and social psychological factors in the decision to seek medical care for symptoms.

Panel data are presented from the Los Angeles Health Survey, in which 1 year of symptom experience is analyzed. Of the 1,210 individuals originally in the panel, 769 reported at least one symptom in reinterviews conducted every 6 weeks during the study year. The dependent variable in the analysis is whether or not the individual decided to seek medical attention for his symptoms. Hierarchical multiple regression was used to organize the independent variables into five groups: 1) need; 2) social structure; 3) organization of care; 4) general social network patterns and health orientations; and 5) social network influences and personal beliefs specific to the symptoms. Of the 57 per cent of the variance explained by the entire set of independent variables, need factors accounted for 12 per cent and network influences and personal beliefs specific to the symptom accounted for 42 per cent. In spite of the amount of variance explained in this analysis, the allocation of the explained variance among the predictor variables raises some disturbing questions regarding our ability to understand the decision to use health services.