Utilization of ambulatory health services by urban adolescents.
OBJECTIVE
To describe adolescents' utilization of ambulatory health services and its association with sociodemographic and health status characteristics.


METHODS
Adolescents (N = 199) were selected from a larger group of urban middle and high school students who had previously participated in a health risk survey. Subjects were surveyed about their health status and use of ambulatory medical services. Subjects' parents/guardians were also surveyed about sociodemographic information. Bivariate and multivariate analyses using Chisquare statistics and logistic regression techniques assessed the contribution of hypothesized variables to use of routine medical, illness-related medical, and dental services.


RESULTS
Most adolescents reported having seen a physician (70%) or a dentist (79%) within the past year. Subjects reported using a wide variety of practitioners and settings, with family/general practitioners (29%), and the private office setting (23%) most commonly reported. Subjects having a regular source of care and those perceiving their health as "excellent" or "very good" were 2.4 and 3.4 times more likely to have used routine medical services than those without a regular source of care and those reporting their health as "fair" or "poor." In contrast, the strongest predictors of having received illness-related care in the past year were the presence of a current medical problem and an age by gender interaction factor. Those reporting a current medical problem were twice as likely as those not reporting a problem and older females were 6.6 times as likely as younger males to have received illness-related care within the past year. The only significant predictor of recent dental care was having private insurance.


CONCLUSIONS
For adolescents enabling variables, such as having a regular source of care and health insurance, are stronger predictors of routine use of medical and dental care, whereas medical need and sociodemographic factors, such as age and gender, are more important in predicting use of illness-related care. These results support, in part, models that have been previously developed to explain use of ambulatory health services.
Ryan
S A
SA
Department of Pediatrics, School of Medicine, University of Maryland at Baltimore 21201, USA.
Millstein
S G
SG
Greene
B
B
Irwin
C E
CE
D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D003752:Dental Health Services / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D007348:Insurance, Health; D016013:Likelihood Functions; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D012959:Socioeconomic Factors; D014504:Urban Health