Date of Award
Doctor of Philosophy (PhD)
Urban Services--Health Services
Ardythe L. Morrow
Katharine C. Kersey
This is a retrospective longitudinal study of health service utilization using the Immunization Practice Data Set obtained from the Center for Pediatric Research, Norfolk, Virginia. Cluster sampling was used to identify a cohort of children (n = 271), aged 0 to 24 months, from the city of Norfolk, Virginia. A two-year abstraction of medical records was used to determine utilization practice patterns for three categories of health: well-baby, acute and chronic care. The purpose of this study was to identify socio-demographic, need, and health system factors associated with under-utilization of primary care services using Aday's model. The proportion of children who met the American Academy of Pediatrics guidelines for the number of preventive care visits was identified.
As a group, half of the children in the first year-of-life failed to meet the AAP guidelines of 5 well-baby visits (mean = 4.64, SD 2.72) while most of those in the second year-of-life slightly exceeded the 3 well-baby visit standard (mean = 4.04, SD 2.47). Compliance in the latter group was 76.60 of the cohort (n = 82) and those that did not meet the AAP specification were 23.4% (n = 25). The mean age of the child at first visit was 8.1 months and represents a highly significant lack of well baby/preventive care visits during the first year of life in the study cohort.
Results of this study concur with prior research in identifying risk factors/variables associated with access to healthcare providers and under utilization of primary care providers. Respondents who tended to under-utilize primary care services and over utilize emergency care providers were Black, single unsupported parents, from low-income families, with low education and those who lacked insurance. The major barriers reported by parents were location, lack of transportation, and cost.
Waibel, Ruth A..
"Barrier to Utilization of Primary Healthcare Resources in Children Two Years of Age and Under"
(2001). Doctor of Philosophy (PhD), dissertation, , Old Dominion University, DOI: 10.25777/chvp-fb68