Factors affecting pediatric preventive care utilization in a prepaid group practice. 1988

S M Horwitz, and H Morgenstern, and L F Berkman
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn.

Previous research on the utilization of pediatric preventive care has shown that certain sociodemographic factors, such as age, birth order, family size and race, as well as health attitudes and beliefs are related to the use of well-child services. To examine the simultaneous effects of sociodemographic, psychosocial and behavioral factors, we conducted a 16-month prospective investigation of 532 children belonging to a university-affiliated prepaired group practice. The children were under 5 years of age upon enrollment and came predominantly from white, middle-class families with well-educated parents. Our bivariable results showed that 13 factors were related to preventive care utilization (p less than 0.05) and, in effect, confirmed findings from previous investigations. However, using model-fitting procedures, we found that only two variables, child's age and birth order, significantly predicted the rate of preventive care visits; a high utilization rate was observed for younger children and for first-born children. Since the observed age-specific rates of preventive care utilization were nearly identical to the schedule recommended by the pediatricians in this practice, we believe that most of the variability in well-child care in our population was due to provider-induced demand. Furthermore, none of the other demographic or psychosocial factors that significantly predicted acute care utilization in this population had any effect on preventive care once age and birth order were accounted for.

UI MeSH Term Description Entries
D009035 Mothers Female parents, human or animal. Mothers' Clubs,Club, Mothers',Clubs, Mothers',Mother,Mother Clubs,Mother's Clubs,Mothers Clubs,Mothers' Club
D011314 Preventive Health Services Services designed for HEALTH PROMOTION. Health Services, Preventive,Preventive Health,Preventive Health Care,Preventive Health Programs,Preventive Programs,Services, Preventive Health,Care, Preventive Health,Health Care, Preventive,Health Program, Preventive,Health Programs, Preventive,Health Service, Preventive,Health, Preventive,Preventive Health Program,Preventive Health Service,Preventive Program,Program, Preventive,Program, Preventive Health,Programs, Preventive,Programs, Preventive Health,Service, Preventive Health
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D001722 Birth Order The sequence in which children are born into the family. First Birth,Birth Orders,Birth, First,Births, First,First Births
D002662 Child Health Services Organized services to provide health care for children. Infant Health Services,Child Services, Health,Health Services, Child,Health Services, Infant,Infant Services, Health,Services, Child Health,Services, Infant Health,Child Health Service,Health Service, Child,Health Service, Infant,Infant Health Service,Service, Child Health,Service, Infant Health
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D006123 Group Practice Any group of three or more full-time physicians organized in a legally recognized entity for the provision of health care services, sharing space, equipment, personnel and records for both patient care and business management, and who have a predetermined arrangement for the distribution of income. Group Practices,Practice, Group,Practices, Group
D006125 Group Practice, Prepaid An organized group of three or more full-time physicians rendering services for a fixed prepayment. Prepaid Group Practice,Group Practices, Prepaid,Practice, Prepaid Group,Practices, Prepaid Group,Prepaid Group Practices
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012923 Social Class A stratum of people with similar position and prestige; includes social stratification. Social class is measured by criteria such as education, occupation, and income. Caste,Social Gradients,Socioeconomic Level,Socioeconomic Status,Middle Class Population,Castes,Class, Social,Gradient, Social,Level, Socioeconomic,Middle Class Populations,Population, Middle Class,Social Classes,Social Gradient,Socioeconomic Levels,Status, Socioeconomic

Related Publications

S M Horwitz, and H Morgenstern, and L F Berkman
January 1974, Transactions of the Association of American Physicians,
S M Horwitz, and H Morgenstern, and L F Berkman
January 1978, Medical care,
S M Horwitz, and H Morgenstern, and L F Berkman
October 1974, The New England journal of medicine,
S M Horwitz, and H Morgenstern, and L F Berkman
December 1962, Archives of environmental health,
S M Horwitz, and H Morgenstern, and L F Berkman
January 1975, The Milbank Memorial Fund quarterly. Health and society,
S M Horwitz, and H Morgenstern, and L F Berkman
November 1988, Journal of medical education,
S M Horwitz, and H Morgenstern, and L F Berkman
December 1981, Medical care,
S M Horwitz, and H Morgenstern, and L F Berkman
January 1978, The Mount Sinai journal of medicine, New York,
S M Horwitz, and H Morgenstern, and L F Berkman
October 1962, Public health reports (Washington, D.C. : 1896),
S M Horwitz, and H Morgenstern, and L F Berkman
December 1978, Journal of the American Optometric Association,
Copied contents to your clipboard!