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The European Journal of Public Health Advance Access published online on April 27, 2006
The European Journal of Public Health, doi:10.1093/eurpub/ckl055
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© The Author 2006. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Received December 14, 2004
Accepted August 18, 2005

Article

Perceived health status and use of healthcare services among children and adolescents

Silvina Berra 1 *, Carme Borrell 2, Luis Rajmil 1, Maria-Dolors Estrada 1, Maica Rodríguez 2, Anne W. Riley 3, Christopher B. Forrest 3, and Barbara Starfield 3

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

* To whom correspondence should be addressed.
Silvina Berra, E-mail: sberra{at}aatrm.catsalut.net


  Abstract

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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