Correlates of healthcare-seeking behavior for acute gastroenteritis—United States, October 1, 2016 –September 30, 2017

• Published in: PloS one 2023-10, Vol.18 (10), p.e0293739-e0293739
• Main Authors: Hallowell, Benjamin D, Burke, Rachel M, Salas, S. Bianca, Groom, Holly, Donald, Judy L, Mattison, Claire P, Schmidt, Mark A, Hall, Aron J
• Format: Article
• Language: English
• Subjects: Analysis; Biology and Life Sciences; Care and treatment; Chronic diseases; Diarrhea; Gastroenteritis; Health behavior; Health maintenance organizations; Help-seeking behavior; Market surveys; Medicine and Health Sciences; People and places; Research and Analysis Methods; Surveillance equipment; Surveys
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0293739

In the United States, public health surveillance systems often underestimate the burden of acute gastroenteritis (AGE) because they only identify disease among those who interact with the healthcare system. To identify factors associated with healthcare-seeking behavior among individuals experiencing community-acquired AGE. From October 2016 -September 2017, we conducted a weekly, age-stratified, random sample of Kaiser Permanente Northwest members located in northwest Oregon and southwest Washington, United States. Individuals who completed the online survey and experienced AGE were included in the analysis. Univariate and multivariable logistic regressions were performed to identify predictors of healthcare-seeking behavior. Of the 3,894 survey respondents, 395 experienced an AGE episode and were eligible for analysis, of whom, 82 (21%) sought care for their AGE episode. In the final multivariable model, individuals with a concurrent fever (odds ratio [OR]: 4.76, 95% confidence interval [95% CI]: 2.48-9.13), increased diarrhea duration ([greater than or equal to]6 days vs 1-4 days, OR: 4.22, 95% CI: 1.78-10.03), or increased vomiting duration ([greater than or equal to]3 days vs 1 days, OR: 2.97, 95% CI: 1.22-7.26), were significantly more likely to seek healthcare. In the adjusted model, no sociodemographic or chronic disease variables were associated with healthcare-seeking behavior. These findings suggest that individuals with a short duration of AGE and those without concurrent fever are underrepresented in healthcare facility-based surveillance systems.