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Social marginalization reduces use of ENT physicians in primary care
Jørgen Lous1, Karina Friis, Anker L Vinding
1Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, DK-5000 Odense C, Denmark. jlous@health.sdu.dk
Objective:
The aim of this study was to explore the association between social marginalization of the mothers and their children's use of the healthcare system and ear-nose-throat (ENT) physicians in the year 2009 in a region of Denmark.
Methods:
A regional register-based cross-sectional study of use of healthcare services among children (n=10,232) of marginalized mothers and children (n=101,582) of non-marginalized mothers in the North Denmark Region. Social marginalization was defined as having received public social benefits for more than 80% of the year.
Results:
Children with a marginalized mother had more chronic medical diagnoses (OR=1.22, 95% confidence interval 1.17-1.28), they had more frequently been in contact with their general practitioner during the year, and they used the healthcare system more often than children of non-marginalized mothers, except in the case of ENT specialists (OR=0.90, 0.85-0.95), and they had more seldom tympanostomy tubes inserted (OR=0.75, 0.66-0.87). The distance between ENT-clinic and place of residence of the patients had only a small effect on the use of ENT-physician, and only significant in the non-marginalized.
Conclusions:
Children of marginalized mothers used the healthcare system more than other children, except in case of ENT-physicians. They had fewer ENT-consultations and had less frequently inserted tympanostomy tubes when they attended the surgery.
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