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Factors affecting children's use of physician services in a prepaid group practice
Insights
Maternal characteristics, child
Area of Science:
- Health Services Research
- Pediatric Healthcare Utilization
- Maternal Health Psychology
Background:
- Understanding factors influencing pediatric healthcare access is crucial for effective public health strategies.
- Prepaid group practices present a unique model for studying healthcare utilization patterns.
- Maternal psychological distress can impact healthcare-seeking behaviors for children.
Purpose of the Study:
- To identify key determinants of physician service utilization among children within a prepaid group practice.
- To differentiate factors influencing the initiation versus the extent of healthcare use.
- To investigate the specific role of maternal psychological distress in pediatric healthcare utilization, considering racial differences.
Main Methods:
- Survey interviews with mothers to collect independent variables.
- Analysis of children's medical records for utilization data.
- Longitudinal measurement of independent variables preceding the utilization period.
Main Results:
- Child's age, health status, and maternal characteristics significantly influence physician service use.
- Distinct factors predict whether services are used versus the magnitude of use.
- Maternal psychological distress impacts utilization extent more than occurrence, particularly in white families.
Conclusions:
- Pediatric healthcare utilization is multifactorial, influenced by child and maternal factors.
- Maternal psychological distress is a relevant, though context-dependent, predictor of healthcare use intensity.
- Further research is needed to understand racial disparities in healthcare-seeking behaviors.
Abstract:
This paper examines factors affecting children's use of physician services in a prepaid group practice. The independent measures come from questions asked of mothers in a survey interview, while the utilization data come from their children's medical records. All independent variables were measured prior to the period of utilization studied. The results provide some evidence in support of the view that physician utilization for children is affected by characteristics of the mother, as well as the child's age and health status. Somewhat different variables were related to whether health services were used at all as compared with magnitude of use. Special consideration is given to the effect of the mother's level of psychological distress on her propensity to use medical services for children. The results suggest that distress was relevant, but only for the white families included in the sample. Also, distress was more important in explaining extent of use than accounting for whether utilization occurred at all. Various hypotheses are examined to explore white-nonwhite differences.