Revisiting predictors of parental health care-seeking behaviors for nonurgent conditions at one inner-city hospital

• Published in: Pediatric emergency care Vol. 25; no. 4; p. 238
• Main Authors: Zandieh, Stephanie O, Gershel, Jeffery C, Briggs, William M, Mancuso, Carol A, Kuder, John M
• Format: Journal Article
• Language: English
• Published: United States 01.04.2009
• Subjects: Adolescent; Child; Child, Preschool; Cost-Benefit Analysis; Cross-Sectional Studies; Diagnosis-Related Groups; Emergency Service, Hospital - economics; Emergency Service, Hospital - statistics & numerical data; Ethnic Groups - statistics & numerical data; Female; Health Services Misuse - economics; Health Services Misuse - statistics & numerical data; Hospitals, Urban - economics; Hospitals, Urban - statistics & numerical data; Humans; Infant; Infant, Newborn; Male; Medicaid - statistics & numerical data; Motivation; New York City - epidemiology; Outpatient Clinics, Hospital - economics; Outpatient Clinics, Hospital - statistics & numerical data; Parents - psychology; Patient Acceptance of Health Care - statistics & numerical data; Patient Satisfaction; Physician-Patient Relations; Physicians, Family; Socioeconomic Factors; United States
• ISSN: 1535-1815
• DOI: 10.1097/PEC.0b013e31819e350e

To determine important predictors of why parents seek care for their children at a pediatric emergency department (ED) compared to their child's primary care provider's (PCP's) walk-in clinic. Cross-sectional study. An inner-city hospital located in New York City, from April 2003 to January 2004. A convenience sample of 170 parents with children younger than 18 years, Medicaid beneficiaries, had a PCP, and presented with a nonurgent medical problem either at the pediatric ED or walk-in clinic. The main outcome measure was the setting in which parents sought care for their child; odds ratios (ORs) were calculated for parents seeking care in the pediatric ED compared to those seeking care at the walk-in clinic, adjusting for predisposing, enabling, and need-related factors. Of the 170 parent-child visits, 87 (51%) were seeking care at the ED and 83 (49%) at their child's walk-in clinic. In logistic regression, single parenting was the strongest predictor for seeking care in the ED (OR, 5.54; 95% confidence interval [CI], 1.4-26.9), followed by Hispanic ethnicity (OR, 4.96; 95% CI, 1.43-17.2), low parental perceptions of their child's physical health (OR, 0.90; 95% CI, 0.82-0.99), controlling for number of chronic conditions, parental working status, and satisfaction with their PCP. Single parenting, Hispanic ethnicity, and perceptions of health are associated with health care-seeking behaviors in high cost settings among Medicaid beneficiaries. Targeted education programs could be used to influence future site of care.