title: Association between maternal and adult offspring utilization of primary healthcare.
abstract: BACKGROUND
  Healthcare behavior occurs within the context of the family unit. Little research has investigated the influences among adult family members regarding their use of medical care services.
  
  
  OBJECTIVE
  To investigate the effects of maternal attendance patterns and maternal self-assessed health status on those of adult children.
  
  
  METHODS
  This study was a retrospective cohort, analyzing both patient records for physician visits and mailed self-administered questionnaires regarding subjective health assessment. We evaluated a unique study group of multi-generational families with free and equal access to medical services at a primary care kibbutz clinic in Israel. This enabled an exclusive focus on the association between the use of healthcare by mothers and their grown children.
  
  
  RESULTS
  Controlling for the subjects' age, gender and number of chronic diagnoses, a significant association exists between the family physician visit rates of a mother and those of her grown offspring (P = 0.03). Low self-health assessment is associated with higher levels of physician utilization (P = 0.003). Maternal self-health evaluation is associated with her adult children's own self-health evaluation (odds ratio 5.9, P = 0.04) and their rates of physician utilization (one additional offspring visit per year for low maternal self-health, P = 0.02).
  
  
  CONCLUSIONS
  A mother's behavior patterns measured via self-rated health status and physician visit rates serve as a proxy for maternal attitudes regarding healthcare, and these attitudes are possibly imparted to her children for life. This study provides unique evidence for a maternal health behavior effect on grown children, and enables a more complete understanding of families attending the primary care clinic.
authors.affiliation: Department of Family Medicine, Hebrew University-Hadassah Medical School, Jerusalem, Israel.
authors.forename: Avraham
authors.initials: A
authors.lastname: Friedman
authors.forename: Amnon
authors.initials: A
authors.lastname: Lahad
mesh_terms: D000293:Adolescent; D000328:Adult; D032721:Adult Children / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D005192:Family Health; D005260:Female; D015438:Health Behavior; D006801:Humans; D007557:Israel; D008297:Male; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009034:Mother-Child Relations; D009819:Office Visits / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires