Family characteristics in high and low health care utilization

Despite the position of the family as the basic social unit, the majority of studies of medical care utilization focus on individuals. In this preliminary study, nine families of high utilizers and 12 families of low utilizers were compared using the Moos Family Environment Scale and a semistructured interview. Significant differences were seen in structure, interactional patterns, and health-related behavior. The high utilizer families, as a whole, saw themselves as less expressive and more achievement-oriented. High utilizer children saw much more parental control than did low utilizer children. There was greater divergence in perspective between husbands and wives of high utilizing families than between spouses in low utilizing families. High utilizer families were less social than low utilizer families. There was greater use of tranquilizers and greater dissatisfaction with doctors in the high utilizer families as well.