The European Journal of Public Health Advance Access originally published online on April 27, 2006
The European Journal of Public Health 2006 16(4):405-414; doi:10.1093/eurpub/ckl055
Children and adolescents |
Perceived health status and use of healthcare services among children and adolescents
Silvina Berra1, Carme Borrell2, Luis Rajmil1, Maria-Dolors Estrada1, Maica Rodríguez2, Anne W. Riley3, Christopher B. Forrest3 and Barbara Starfield3
1 Catalan Agency for Health Technology Assessment and Research (CAHTA), Barcelona, Spain
2 Agency for Public Health of Barcelona, Spain
3 Johns Hopkins University, Baltimore, USA
Correspondence: Silvina Berra, Catalan Agency for Health Technology Assessment and Research, Parc Sanitari Pere Virgili, Esteve Terradas, 30, ES-08023 Barcelona, Spain, tel: +34 93 259 42 00, fax +34 93 259 42 01, e-mail: sberra{at}aatrm.catsalut.net
Background: The aim of the present study was to analyse the use of healthcare services according to health status in a population of children and adolescents, taking into account family socio-demographic characteristics and characteristics of the proxy respondent. Methods: A total of 836 interviews of proxy respondents for children aged 5–14 years from the Barcelona Health Interview Survey carried out in 2000 were included. Dependent variables were visits to a healthcare professional, visits to the emergency room, and hospitalization. Independent variables were: report of medical conditions, health status of the child measured by the Child Health and Illness Profile-Child Edition, Parent Report Form (CHIP-CE/PRF), the educational level of the head of household, social class, child's healthcare coverage, and proxy-related variables [mental health status by means of the General Health Questionnaire-12 items version (GHQ-12), and other]. Logistic regression analysis was used to estimate prevalence ratio (PR) to compare the use of healthcare services among different categories of independent variables. Results: Children having worse health status were more likely to have visited a healthcare professional [PR = 1.68; 95% confidence interval (95% CI) = 1.09–3.83], whereas children with a reported medical condition were more likely to have made a visit to the emergency service (PR = 1.47; 95% CI = 1.27–2.55) and were hospitalized more frequently (PR = 2.50; 95% CI = 1.12–5.57). Higher likelihood of visits to the emergency room was associated with children having both public and private coverage and a proxy respondent scoring 3 or higher on the GHQ-12. Conclusions: Use of healthcare services differed by health needs but not by social class. Double healthcare coverage and mental distress of the proxy respondent influenced the use of emergency services.
Keywords: child health care, health services, health status, mental health
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