Does participation in preventive child health care at the general practitioner minimise social differences in the use of specialist care outside the hospital system?
BACKGROUND
The primary purposes of preventive child health care in Denmark are to help ensure a healthy childhood and to create preconditions for a healthy adult life. The aim of this study is to examine whether participation in age-appropriate preventative child health care affects the association between the socioeconomic position of the family and subsequent use of specialised health care outside the hospital system.


METHODS
The study population was children born in 1999 and living in Denmark between 1 January 2002 and 31 December 2006 (n=68,366). The study investigated whether the number of contacts with a specialist in 2006 was related to participation in preventive child health care between 2002 and 2005. To control for the potential effect of difference in GP behaviour the data were analysed using a multilevel Poisson model linking each child to the GP with whom he or she was listed.


RESULTS
If the children attended any preventive child health care visits, they had the same probability of contact with a specialist regardless of the parents' income. However, children from low-income families not participating in any preventive care had a lower probability of contact with a specialist than children from more affluent families.


CONCLUSIONS
Ensuring participation in preventive child health care at the GP may reduce the social gap in utilisation of specialised health care that exists between children from families of different income levels.
Danish Institute for Health Services Research, Copenhagen, Denmark.
Solvej
S
Mårtensson
Kristine Halling
KH
Hansen
Kim Rose
KR
Olsen
Torben Brunse
TB
Højmark
Jørgen Holm
JH
Petersen
Pernille
P
Due
D002662:Child Health Services / Q000706:statistics & numerical data*; D002669:Child Welfare; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012307:Risk Factors; D012923:Social Class; D013038:Specialization / Q000706:statistics & numerical data*