Revisiting predictors of parental health care-seeking behaviors for nonurgent conditions at one inner-city hospital.
BACKGROUND
To determine important predictors of why parents seek care for their children at a pediatric emergency department (ED) compared to their child's primary care provider's (PCP's) walk-in clinic.


METHODS
Cross-sectional study.


METHODS
An inner-city hospital located in New York City, from April 2003 to January 2004.


METHODS
A convenience sample of 170 parents with children younger than 18 years, Medicaid beneficiaries, had a PCP, and presented with a nonurgent medical problem either at the pediatric ED or walk-in clinic.


METHODS
The main outcome measure was the setting in which parents sought care for their child; odds ratios (ORs) were calculated for parents seeking care in the pediatric ED compared to those seeking care at the walk-in clinic, adjusting for predisposing, enabling, and need-related factors.


RESULTS
Of the 170 parent-child visits, 87 (51%) were seeking care at the ED and 83 (49%) at their child's walk-in clinic. In logistic regression, single parenting was the strongest predictor for seeking care in the ED (OR, 5.54; 95% confidence interval [CI], 1.4-26.9), followed by Hispanic ethnicity (OR, 4.96; 95% CI, 1.43-17.2), low parental perceptions of their child's physical health (OR, 0.90; 95% CI, 0.82-0.99), controlling for number of chronic conditions, parental working status, and satisfaction with their PCP.


CONCLUSIONS
Single parenting, Hispanic ethnicity, and perceptions of health are associated with health care-seeking behaviors in high cost settings among Medicaid beneficiaries. Targeted education programs could be used to influence future site of care.
Zandieh
Stephanie O
SO
Department of Pediatrics, Weill Medical College of Cornell University, NY, NY 10065, USA. stz2001@med.cornell.edu
Gershel
Jeffery C
JC
Briggs
William M
WM
Mancuso
Carol A
CA
Kuder
John M
JM
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D003953:Diagnosis-Related Groups; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006300:Health Services Misuse / Q000191:economics / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D009042:Motivation; D009519:New York City / Q000453:epidemiology; D010044:Outpatient Clinics, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010821:Physicians, Family; D012959:Socioeconomic Factors; D014481:United States