title: Perceived health status and use of healthcare services among children and adolescents.
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.
authors.affiliation: Catalan Agency for Health Technology Assessment and Research (CAHTA), Barcelona, Spain. sberra@aatrm.catsalut.net
authors.forename: Silvina
authors.initials: S
authors.lastname: Berra
authors.forename: Carme
authors.initials: C
authors.lastname: Borrell
authors.forename: Luis
authors.initials: L
authors.lastname: Rajmil
authors.forename: Maria-Dolors
authors.initials: MD
authors.lastname: Estrada
authors.forename: Maica
authors.initials: M
authors.lastname: Rodríguez
authors.forename: Anne W
authors.initials: AW
authors.lastname: Riley
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Forrest
authors.forename: Barbara
authors.initials: B
authors.lastname: Starfield
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D013030:Spain; D011795:Surveys and Questionnaires; D014505:Urban Population