Preventive and episodic health care of inner-city children

Children in low-income, inner-city households who used different sources of ambulatory care were analyzed with regard to their experiences in securing preventive and episodic illness care. This analysis is derived from a larger study that investigated the utilization of health care systems by groups within an inner-city community; it focused on the Outpatient Department of a large teaching hospital and on the impact of a new Health Maintenance Organization (HMO). Data were obtained through household interviews of three sample populations: enrollees in an HMO, residents of a public housing project, and persons from the general community. When preventive health care was examined, our findings showed that, while the majority of children of school age were immunized, only about half of the children under age 6 were. Among children aged 3 through 5, those attending day care centers were more likely to be immunized than those not in such programs. There were indications that children using the HMO were more frequently receiving preventive services, particularly general physical examinations. There was no relationship between the usual source of care, or day care participation, and whether a child received care for an episode of illness. There were differences by age and usual source of care in seeking care for earaches and in receiving regular care for asthma. The patterns of health care utilization found in this study promote interest in the influence of the source of ambulatory care for children in other socioeconomic groups.