Social marginalization reduces use of ENT physicians in primary care.
OBJECTIVE
The aim of this study was to explore the association between social marginalization of the mothers and their children's use of the healthcare system and ear-nose-throat (ENT) physicians in the year 2009 in a region of Denmark.


METHODS
A regional register-based cross-sectional study of use of healthcare services among children (n=10,232) of marginalized mothers and children (n=101,582) of non-marginalized mothers in the North Denmark Region. Social marginalization was defined as having received public social benefits for more than 80% of the year.


RESULTS
Children with a marginalized mother had more chronic medical diagnoses (OR=1.22, 95% confidence interval 1.17-1.28), they had more frequently been in contact with their general practitioner during the year, and they used the healthcare system more often than children of non-marginalized mothers, except in the case of ENT specialists (OR=0.90, 0.85-0.95), and they had more seldom tympanostomy tubes inserted (OR=0.75, 0.66-0.87). The distance between ENT-clinic and place of residence of the patients had only a small effect on the use of ENT-physician, and only significant in the non-marginalized.


CONCLUSIONS
Children of marginalized mothers used the healthcare system more than other children, except in case of ENT-physicians. They had fewer ENT-consultations and had less frequently inserted tympanostomy tubes when they attended the surgery.
Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, DK-5000 Odense C, Denmark. jlous@health.sdu.dk
Jørgen
J
Lous
Karina
K
Friis
Anker L
AL
Vinding
Kirsten
K
Fonager
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003718:Denmark; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D008297:Male; D009035:Mothers; D010036:Otolaryngology; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012923:Social Class; D012959:Socioeconomic Factors