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Factors affecting pediatric preventive care utilization in a prepaid group practice
S M Horwitz1, H Morgenstern, L F Berkman
1Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn.
Pediatrician
|January 1, 1988
Summary
Pediatric preventive care use is primarily influenced by child's age and birth order, not other demographic or psychosocial factors. This suggests provider-induced demand significantly impacts well-child visit frequency.
Area of Science:
- Pediatrics
- Health Services Research
- Preventive Medicine
Background:
- Previous studies indicate sociodemographic and health beliefs influence pediatric preventive care utilization.
- Well-child services are crucial for monitoring child development and early disease detection.
Purpose of the Study:
- To investigate the simultaneous effects of sociodemographic, psychosocial, and behavioral factors on pediatric preventive care utilization.
- To identify key predictors of well-child service use in young children.
Main Methods:
- A 16-month prospective study of 532 children under five years old.
- Data collected from a university-affiliated group practice, predominantly serving white, middle-class families.
- Bivariable and model-fitting analyses were used to assess factor significance.
Main Results:
- Initially, 13 factors were found to be related to preventive care use.
- Only child's age and birth order significantly predicted preventive care visit rates.
- Younger children and first-born children showed higher utilization rates.
Conclusions:
- Child's age and birth order are the primary drivers of preventive care visits in this population.
- Observed utilization rates closely matched recommended schedules, suggesting provider-induced demand.
- Other demographic and psychosocial factors did not significantly impact preventive care use after accounting for age and birth order.