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[Primary care resources use variation by under seven year old children in a rural and an urban area. Cohort study]
D Oterino de la Fuente1, R Martín Díaz, L A Díaz Megido
1Fundación Instituto de Investigación en Servicios de Salud. Asturias. España. Centro de Salud de Teatinos. Asturias. España. doterino@eresmas.net
Insights
Primary care resource use, including attention episodes and diagnosis tests, was significantly higher in the urban health district (UD) compared to the rural health district (RD). This study highlights disparities in healthcare utilization between urban and rural settings.
Area of Science:
- Public Health
- Healthcare Management
- Pediatric Care
Background:
- Primary care resource utilization can vary significantly between different geographical settings.
- Understanding these differences is crucial for equitable healthcare planning and resource allocation.
- Previous studies have indicated potential disparities in healthcare access and utilization between urban and rural populations.
Purpose of the Study:
- To compare primary care resource utilization between a rural health district (RD) and an urban health district (UD).
- To identify specific areas of difference in healthcare resource use for children aged 0-6 years.
- To inform targeted interventions for optimizing primary care services in diverse settings.
Main Methods:
- Retrospective population cohort study design.
- Inclusion of children born in 1991 (UD) and 1991-1992 (RD), registered in primary care centers from birth to 6 years old.
- Analysis of key metrics: attention episodes, requested visits, practitioner-programmed visits, nursery-programmed visits, and diagnosis tests.
Main Results:
- Urban health district (UD) showed significantly higher averages for attention episodes and requested visits compared to the rural health district (RD).
- Higher rates of practitioner-programmed and nursery-programmed visits were observed in the RD.
- A greater proportion of children in the UD received at least one diagnosis test (90.3% vs. 64.8% in RD).
- The UD had more requested visits and diagnosis tests per attention episode than the RD.
Conclusions:
- Primary care services utilization, including attention episodes and diagnosis tests, is demonstrably higher in the urban health district compared to the rural district.
- Significant differences in resource use highlight potential inequities in healthcare access or patterns of care between urban and rural children.
- Further research is warranted to explore the underlying factors contributing to these utilization disparities and to develop strategies for more equitable primary care delivery.
Objective:
[corrected] To describe differences between two health districts in primary care resource use.
Design:
Retrospective population cohort study.
Setting:
A rural healthdistrict (RD) and an urban health district (UD).
Participants:
A cohort of children born in 1991 in a UD (n=104) and a cohort of children born in 1991 and 1992 in an RD (n=88), registered in their primary care centres between 0 and 6 years old.
Main Measurements:
Attention episodes, requested visits, practicioner programmed visits, nursery programmed visits and diagnosis tests.
Results:
Significative differences were noticed in the attention episode average(ZU=34.0; 95% CI, 31.5%-36.5%); (ZR=25.6; 95% CI, 22.7%-28.5%), in requested visits (ZU=45.8; 95% CI, 41.8%-49.9%); (ZR=28.8; 95% CI, 25.3%-31.9%), in practicioner programmed visits (ZU=7.1; 95% CI, 6.6%-7.5%), (ZR=11.2; 95% CI, 10.7%-11.7%) and in nursery programmed visits (ZU=9.8; 95% CI, 9.0%-10.6%) (ZR=12.0; 95% CI, 11.4%-12.5%). At least one diagnosis test was applied to 90.3% of children in the UD and to 64.8% of children in the RD; and in the UD for each attention episode 1.32 (95% CI, 1.28%-1.36%) requested visits were attended to and 0.2 (95% CI, 0.17%-0.23%) diagnosis tests were made; whereas in the RD 1.1 (95% CI, 1.08%-1.13%) requested visits and 0.09 (95% CI, 0.06%-0.12%) diagnosis tests. In both health districts the average of attention episodes, requested visits and tests was significantly higher in children who had been hospitalized.
Conclusions:
Primary care services utilization and the number of diagnosis test and attention episode visits are higher in the urban district than in the rural one.
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