Factors Associated with Health Service Use for Self-Reported Balance Problems in Community-Dwelling Adults: A Secondary Analysis of Nationally Representative NHANES 2001–2004 Data

TL;DR

This study finds that only a third of adults with balance problems seek healthcare, with factors like age and insurance affecting utilization.

Contribution

The study identifies novel associations between healthcare use for balance problems and factors like health insurance and recent falls.

Findings

Only 32.13% of adults with balance problems sought healthcare.

Health insurance and recent healthcare encounters increased utilization.

Older age was linked to lower healthcare use for balance issues.

Abstract

Background: Balance problems are one of the major risk factors for falls. Despite the availability of effective fall prevention interventions, falls and related injuries are rising. This study explored the factors associated with healthcare utilization for balance problems in community-dwelling adults in the United States. Methods: Study involved secondary analysis of nationally representative National Health and Nutrition Examination Survey 2001–2004 data (latest data with variables of interest at the time of study). All adults (≥40 years) who reported balance problems in the past 12 months were included. Dependent variable was whether the individual ever saw a healthcare professional for balance problems. All analyses were adjusted for probability sampling weights. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated using multivariable logistic regression. Results: Study included 1834 adults with self-reported balance problems (mean age 60.1 years (0.5 SE), 62.3% females). Of these, only 32.13% ever saw a healthcare professional for their balance problems. Having encounter(s) with a healthcare provider for any reason in the past year (AOR 2.45; 95% CI,1.19–5.06; p = 0.017), lack of health insurance (AOR 0.52; 95% CI,0.32–0.84; p = 0.009), falls in the past year (AOR, 1.29; 95% CI,1.03–1.61; p = 0.028) and age (AOR, 0.98; 95% CI,0.97–0.996; p = 0.011) had significant association with healthcare utilization for balance problems. The predicted probability of healthcare use for balance problems decreased from 0.39 for 40-year-olds to 0.26 for 80-year-olds. Conclusions: This study reports the association between factors such as age, health insurance, encounter with a healthcare provider, and falls in the past year with healthcare utilization for balance problems among community-dwelling adults with self-reported balance problems and identifies populations at increased risk of underutilization. Despite the use of older data, it provides useful information for guiding future research in this novel domain of healthcare research.

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