This study assessed the ability of minor life events to predict medical utilization among 141 low-income, predominantly African American family practice patients. Subjects completed one year of stress assessments including major and minor life events. Four years of prospective medical utilization was collected, including outpatient, inpatient, and emergency department visits. Hierarchical regressions were conducted to assess the predictive value of minor life events for utilization, after controlling for demographic variables and major life events. The impact of minor life events was a significant predictor of outpatient utilization, accounting for 3.6% of the variance. Minor life events were unrelated to emergency department and inpatient visits. The relationship between minor life events and some types of utilization suggests traditional stress management techniques may be beneficial in reducing utilization for some patients, although such conclusions are tempered by the modest relationship between stress and utilization.
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Examining the plots of the distributions raised questions about the normality of the utilization data distributions and residuals. The utilization data can be considered as count data, and indeed the plots were suggestive of an over-dispersed Poisson distribution. The analyses were repeated using the generalized model for Poisson regression (SAS v8 Proc GenMod). As all the results remained substantially the same, the more easily interpretable regression results are presented here.
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ACKNOWLEDGMENTS
This study was funded by a grant (RO1MH51194) from the National Institute of Mental Health (NIMH). We would like to thank Steve Ames, Brad Applegate, Melanie Boyce, Shawn Jeffries, Daniel Mehan, and Isabel Scarinci for assistance in data collection.
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Brantley, P.J., Dutton, G.R., Grothe, K.B. et al. Minor Life Events as Predictors of Medical Utilization in Low Income African American Family Practice Patients. J Behav Med 28, 395–401 (2005). https://doi.org/10.1007/s10865-005-9001-z
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DOI: https://doi.org/10.1007/s10865-005-9001-z