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Preventive and episodic health care of inner-city children
Insights
Children
Area of Science:
- Pediatrics
- Health Services Research
- Public Health
Background:
- Inner-city children face unique challenges in accessing healthcare.
- Understanding healthcare utilization patterns is crucial for improving child health outcomes.
- The impact of different ambulatory care sources on preventive and episodic care for children is not well-defined.
Purpose of the Study:
- To analyze the experiences of children in low-income, inner-city households in obtaining preventive and episodic illness care.
- To compare healthcare access and utilization among children enrolled in a Health Maintenance Organization (HMO), public housing residents, and the general community.
- To investigate the influence of the usual source of ambulatory care on preventive service uptake and episodic illness management.
Main Methods:
- Household interviews were conducted with three distinct population samples.
- Data collection focused on preventive care (immunizations, physical exams) and episodic illness care.
- Analysis examined the relationship between the usual source of care, day care participation, and healthcare access.
Main Results:
- While most school-aged children were immunized, only half of those under age 6 received full immunizations.
- Children attending day care centers showed higher immunization rates compared to those not in such programs.
- Children utilizing the HMO appeared to receive preventive services, including physical exams, more frequently.
- No significant relationship was found between the usual source of care or day care participation and receiving care for illness episodes.
- Age and usual source of care influenced seeking care for earaches and managing asthma.
Conclusions:
- Healthcare source influences preventive care access for young children, with HMOs showing potential benefits.
- Day care participation is associated with higher immunization rates.
- Further research is needed to understand the impact of ambulatory care sources on children across diverse socioeconomic groups.
Abstract:
Children in low-income, inner-city households who used different sources of ambulatory care were analyzed with regard to their experiences in securing preventive and episodic illness care. This analysis is derived from a larger study that investigated the utilization of health care systems by groups within an inner-city community; it focused on the Outpatient Department of a large teaching hospital and on the impact of a new Health Maintenance Organization (HMO). Data were obtained through household interviews of three sample populations: enrollees in an HMO, residents of a public housing project, and persons from the general community. When preventive health care was examined, our findings showed that, while the majority of children of school age were immunized, only about half of the children under age 6 were. Among children aged 3 through 5, those attending day care centers were more likely to be immunized than those not in such programs. There were indications that children using the HMO were more frequently receiving preventive services, particularly general physical examinations. There was no relationship between the usual source of care, or day care participation, and whether a child received care for an episode of illness. There were differences by age and usual source of care in seeking care for earaches and in receiving regular care for asthma. The patterns of health care utilization found in this study promote interest in the influence of the source of ambulatory care for children in other socioeconomic groups.
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