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Effect of a pediatric self-care book on utilization of services in a group model HMO

E K France1, M J Selna, E E Lyons

  • 1Department of Preventive Medicine, Kaiser Permanente Colorado, Denver 80231, USA.

Clinical Pediatrics
|January 5, 2000
PubMed

Insights

A pediatric self-care book (SCB) with nurse support reduced health service use in young children. This intervention lowered sick visits, calls, and prescriptions for non-first-borns.

Area of Science:

  • Pediatric Healthcare
  • Health Services Research
  • Patient Education

Background:

  • Promoting self-care empowers families to manage common childhood health issues.
  • Effective health education strategies can influence healthcare utilization patterns.
  • Understanding factors affecting pediatric health service use is crucial for resource management.

Purpose of the Study:

  • To evaluate the impact of a pediatric self-care book (SCB) combined with nurse telephone support on healthcare service utilization.
  • To assess changes in sick visits, nurse calls, pharmacy prescriptions, emergency department visits, and hospital admissions.
  • To determine the effectiveness of a self-care intervention in a pediatric population.

Main Methods:

  • A randomized controlled study involving 1,104 pediatric patients (infant and toddler groups) in a suburban health maintenance organization.
  • Intervention group received a pediatric self-care book and orientation; control group did not.
  • Health service utilization rates (sick visits, advice nurse calls, pharmacy prescriptions, ED visits, hospital admissions) were compared between groups.

Main Results:

  • The SCB group demonstrated a 14.0% reduction in total visits (excluding well-baby visits) compared to controls (p = 0.018).
  • Significant decreases were observed in sick visits (23%), advice nurse calls (24%), and pharmacy prescriptions (26%) for non-first-born infants and toddlers.
  • No statistically significant differences in outcomes were found among first-born children.

Conclusions:

  • A pediatric self-care book with nurse support effectively reduces healthcare service utilization in families with young children.
  • The intervention shows particular benefit for non-first-born children, suggesting targeted support may be beneficial.
  • Promoting self-care within a group model health maintenance organization is a viable strategy to decrease service use.

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