title: Youth health care utilization in Nova Scotia: what is the role of age, sex and socio-economic status?
abstract: OBJECTIVE
  Youth have distinct health care needs that are not always met within a framework designed for children or adults. In Canada, little attention has been given to how youth utilize health care services and limited data are available. The aim of this study was to identify whether age, sex, socio-economic status (SES) and geographic location were significant mediators of youth health care utilization in Nova Scotia.
  
  
  METHODS
  The NSYOUTHS database comprises health care utilization information for all youth aged 12 to 24 years, resident in Nova Scotia between 1997 and 2007. We calculated health care utilization rates by provider, stratified by sex, age, SES, urban/rural residence and year. Negative binomial regression was used to model the variation in health care utilization by sex, SES and urban/rural location.
  
  
  RESULTS
  Health care utilization declined over time and varied by age. Females were more frequent users of services. Youth from lower SES areas had fewer family physician contacts but more outpatient, emergency and inpatient contacts compared to those from higher SES areas. Rural residents had fewer family physician and emergency contacts but more outpatient contacts than youth from urban areas. Ten percent of the youth were responsible for 32% of all health care contacts, whereas 11% had no health care contacts.
  
  
  CONCLUSIONS
  Specific subgroups, including youth from rural areas and of lower SES, utilize health care services differently than other youth. The challenge is to provide health care that is responsive to the needs of this heterogeneous population. Meeting this challenge requires accurate information on youth health care utilization.
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Manos
authors.forename: Yunsong
authors.initials: Y
authors.lastname: Cui
authors.forename: Noni N
authors.initials: NN
authors.lastname: MacDonald
authors.forename: Louise
authors.initials: L
authors.lastname: Parker
authors.affiliation: Dalhousie University. trevor.dummer@dal.ca.
authors.forename: Trevor J B
authors.initials: TJ
authors.lastname: Dummer
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009674:Nova Scotia; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D012923:Social Class; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Youth; geography; health service utilization; socio-economic status