Black-white differences in health care utilization among US children with frequent ear infections.
OBJECTIVE
To examine differences in patterns of and barriers to health care utilization between black and white children who have frequent ear infections (FEI).


METHODS
Analysis was conducted using the 1997 and 1998 National Health Interview Survey-Sample Child Files. Data on 25 497 children under 18 years of age and 1985 who were reported by the parent/guardian to have had "3 or more ear infections during the past 12 months" were analyzed. The data were weighted and analyzed to represent all black and white children nationwide, accounting for the complex survey design.


RESULTS
Of white and black children under 18 years of age in the United States, 8.0 and 6.6%, respectively, had FEI in the past year. Among those with FEI, whites and blacks exhibited significantly different patterns in the type of health insurance they had and in the usual source of care. After accounting for sociodemographic factors, health insurance, and usual source of care, there were still significant differences in health care use between whites and blacks. The affected black children had an increased risk of getting delayed care because of transportation problems (odds ratio [OR]: 2.32) and a reduced likelihood of seeing a medical specialist (OR: 0.49) and having surgery (OR: 0.39) in comparison to white children.


CONCLUSIONS
Although black children with FEI were as likely as white children to be covered by health insurance and have a usual place of health care, they were significantly more likely to face barriers in obtaining the care, especially the more specialized care.
Park
Christina H
CH
Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, Maryland 20857, USA. cpark1@hrsa.gov
Kogan
Michael D
MD
Overpeck
Mary D
MD
Casselbrant
Margaretha L
ML
D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D016001:Confidence Intervals; D004427:Ear Diseases / Q000628:therapy*; D005260:Female; D006302:Health Services Research; D006801:Humans; D007239:Infections / Q000628:therapy; D007348:Insurance, Health / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010372:Pediatrics / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data