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Factors associated with variation in the consultation rates of children aged under five years
Insights
Mothers
Area of Science:
- Pediatrics
- General Practice
- Health Services Research
Background:
- Parental decisions significantly influence healthcare utilization for young children.
- Understanding factors affecting consultation rates is crucial for optimizing primary care services.
Purpose of the Study:
- To identify factors associated with parent-initiated consultations for children under five in a general practice setting.
- To explore the relationship between maternal perceptions of illness urgency and healthcare-seeking behavior.
Main Methods:
- A study was conducted in a large urban general practice, including 294 families with children under five.
- Data collected included parent-initiated consultations from records and maternal responses to hypothetical illness scenarios via questionnaire.
- Factors analyzed included maternal reaction urgency, preschool attendance, child's age, family size, maternal employment, and parental marital status.
Main Results:
- Higher consultation rates were linked to mothers' urgent reactions to illness and children attending preschool.
- Lower consultation rates were observed in younger children, larger families, mothers with less outside employment, and single-parent families.
- No socioeconomic gradient or association with specific diagnostic categories was found.
Conclusions:
- Maternal perception of illness urgency and child's preschool attendance are key drivers of healthcare consultations.
- Factors such as family structure and maternal employment status also play a role in consultation frequency.
- These findings can inform strategies for managing primary care resources and supporting families.
Abstract:
In a large urban practice, all families with a child aged under five years were identified and, after suitable exclusions, 294 (80%) of the 369 families approached cooperated in the study. For each child, the number of parentinitiated first consultations in a one-year period was extracted from general practice records, and mothers were asked to provide additional information by postal questionnaire, which included a test of the mother's reaction to a series of hypothetical child ;illness situations'.The most important factors found to be associated with higher rates of consultation were increased urgency of the mother's reaction to the test situations and attendance of the child at a pre-school group. Children with low consultation rates tended to be younger and more likely to come from larger families; their mothers generally spent less time in regular employment outside the home and were more likely to be single parents. The effect of family size was independent of maternal age and no socioeconomic gradient was found. There was also no evidence that differences in frequency of consultation were related to particular diagnostic categories. The mothers' sources of advice in the postulated event of their child becoming unwell are also described.