The influence of migratory background and parental education on health care utilisation of children.
School-entry screening data from North Rhine-Westphalia (NRW), Germany from 2007 were used to investigate child health care utilisation. We focussed on the influence of migratory background and parental education on children's (1) participation in regularly scheduled early recognition examinations, (2) immunisation uptake and (3) referrals due to a school-entry screen-detected complaint. The study sample consisted of 52,171 children out of 17 NRW districts. Bivariable, stratified and multivariable analyses were performed to identify relevant associations between social determinants and health care utilisation outcome parameters. Multivariable logistic regression showed that children belonging to families with a migratory background or low parental education were more likely to have an incomplete documentation of early recognition examinations and to be referred due to a new diagnosis. Children with migratory background were more likely to be sufficiently immunised than children with parents of German ethnicity. For all studied health care utilisation outcomes, kindergarten visit had a supportive effect.


CONCLUSIONS
In general, the results of our regional study were in line with the results from national population-based studies. Additionally, a larger likelihood of referrals due to school-screen-detected deficits in children with migratory background or low parental education was detected.
Department of International Health, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands. nicole.rosenkoetter@maastrichtuniversity.nl
Nicole
N
Rosenkötter
Martien C J M
MC
van Dongen
Wolfgang
W
Hellmeier
Klaus
K
Simon
Pieter C
PC
Dagnelie
D002648:Child; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D005858:Germany; D006801:Humans; D007802:Language; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D010290:Parents; D012572:School Health Services / Q000706:statistics & numerical data*; D014171:Transients and Migrants / Q000706:statistics & numerical data*; D014611:Vaccination / Q000706:statistics & numerical data*