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Health services use by children enrolled in a hospital-based primary care clinic: a longitudinal perspective
Insights
Child healthcare utilization patterns, including primary care and emergency room visits, are established early. Consistent patterns of frequent or infrequent use for health maintenance and illness care emerge within the first year of life.
Area of Science:
- Pediatrics
- Health Services Research
- Child Health Outcomes
Background:
- Understanding healthcare utilization patterns in children is crucial for effective resource allocation and patient management.
- Early identification of consistent healthcare users can inform targeted interventions.
- Previous research indicates variability in pediatric healthcare access and use.
Purpose of the Study:
- To analyze longitudinal patterns of healthcare utilization among children enrolled in a hospital-based primary care clinic.
- To identify predictors of frequent and infrequent use of primary care (health maintenance and illness) and emergency room services.
- To determine if healthcare utilization patterns are established early in life.
Main Methods:
- A 3-year longitudinal study monitored healthcare use in 293 children enrolled in a primary care clinic since infancy.
- Data collected included visits for health maintenance, illness care, and emergency room use.
- Statistical analysis identified trends and predictors associated with consistent frequent or infrequent utilization.
Main Results:
- Consistent patterns of frequent or infrequent use were observed across primary care and emergency room services.
- Infrequent users often registered later, had more siblings, or showed consistent low use.
- Frequent users often registered early, had multiple chronic conditions, or demonstrated sustained high use.
Conclusions:
- Healthcare utilization patterns in children are established early, often within the first year of life.
- Predictors such as age at enrollment, number of siblings, and chronic conditions influence these patterns.
- Findings suggest that early intervention and consistent engagement with primary care are key to shaping long-term healthcare behaviors.
Abstract:
The use of a hospital-based primary care clinic for health maintenance and illness care and use of the emergency room were monitored for 3 years for 293 children who had been enrolled in the clinic as infants. Infrequent users of one facet of care were infrequent users of other facets of care, and they remained so for all 3 years. The same trends were noted for frequent users. Children who used the clinic for health maintenance infrequently were more likely to have registered in the clinic after 2 months of age and to demonstrate consistently infrequent use throughout the 3 years. Children who used the clinic for illness care infrequently were more likely to have at least two siblings and to demonstrate consistently infrequent use. Children who used the emergency room infrequently were likely to have been consistently infrequent users for emergencies and illness throughout the 3 years. Conversely, those who used the clinic frequently for health maintenance were more likely to have registered before 1 month of age, to have multiple chronic conditions, and to demonstrate consistently frequent use for maintenance throughout the 3 years. Frequent users for illness care were more likely to have none or one sibling, multiple chronic conditions, and to demonstrate consistently frequent use for illnesses. Finally, children who used the emergency room frequently were likely to have multiple chronic conditions and to demonstrate sustained frequent use throughout the 3 years. These results suggest that patterns of use are established as early as the first year of life.