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Characteristics of children with high and low usage of physician services
1Institute for Health Policy Studies, School of Medicine, University of California, San Francisco 94143-0936.
Insights
Child health conditions significantly impact physician service use. Children with multiple health issues were high users, while those with none were low users, highlighting the need for targeted healthcare access.
Area of Science:
- Pediatric healthcare utilization
- Public health research
- Health services research
Background:
- Understanding physician service utilization in children is crucial for effective healthcare planning.
- Previous research indicates variations in healthcare access among pediatric populations.
- The 1988 National Health Interview Survey provides a valuable dataset for analyzing child health trends.
Purpose of the Study:
- To examine the sociodemographic and health-related factors influencing physician service utilization among children.
- To identify patterns of both low and high physician service usage in the pediatric population.
- To investigate the predictive power of health conditions on healthcare access for children.
Main Methods:
- Analysis of a large national dataset: Child Health Supplement to the 1988 National Health Interview Survey.
- Inclusion of 17,110 children under 18 years of age.
- Statistical examination of sociodemographic variables and child health characteristics in relation to physician contacts.
Main Results:
- Children averaged 3 physician contacts, but usage varied significantly (21% no use, 7% high use).
- Sociodemographic factors (age, ethnicity, income, insurance, residence, mother's education) correlated with low usage.
- Childhood health conditions were strong predictors: multiple conditions increased high usage likelihood eightfold and decreased low usage likelihood.
- Demographic and socioeconomic factors were modest predictors of high usage.
Conclusions:
- Childhood health status is a primary driver of physician service utilization, more so than sociodemographic factors.
- Targeted interventions may be needed for children with low physician service usage, particularly those without significant health conditions.
- Understanding these utilization patterns is essential for optimizing pediatric healthcare resource allocation and delivery.
Abstract:
This study examines utilization of physician services using a sample of 17,110 children younger than 18 years from the Child Health Supplement to the 1988 National Health Interview Survey on Child Health. Although children averaged 3 contacts with physicians, 21% of children did not use physician services and 7% had 10 or more contacts and accounted for 37% of all contacts for children during 1988. Age and ethnicity of the child; family income, health insurance status, size, and area of residence; and mother's educational attainment were important sociodemographic correlates of low usage. In contrast, demographic and socioeconomic characteristics were found to be only modest predictors of high usage. Children's health characteristics, especially number of childhood health conditions, were highly predictive of both high and low physician services usage. Compared with children who had no reported conditions, children with multiple conditions were eight times as likely to be high users and were only a fourth as likely to be low users. Implications of these results are discussed.