Family structure and children's use of ambulatory physician services

The purpose of this article is to examine children's use of ambulatory physician services in relation to three dimensions of family life: maternal employment, single-parent versus two-parent households, and the presence of a nuclear or extended family. Data from the National Medical Care Expenditure Survey show that maternal employment has no relationship to children's experience of disability days, and although children of mothers employed full-time are less likely to have a physician contact than are other children, this is attributable to a lower probability of seeing a doctor for children in good health (i.e., no disability days). Multivariate analysis confirms that although maternal employment decreases the likelihood of an ambulatory physician visit (among children with no disability days), it does not affect the total number of ambulatory physician visits or the likelihood of a telephone consultation with the child's physician. Children in single-parent families are more likely to see a physician when they have no disability days, than are children in families with two parents present. Children in nuclear rather than extended families do not differ in patterns of use, even when the mother works. Aside from other characteristics that might be expected to affect use (e.g., age, health status, insurance coverage, a usual source of care), there is a clear relationship between likelihood and volume of use by mothers and children.