The role of parental health care utilization in children’s unnecessary utilization in China: evidence from Shaanxi province

Abstract

BackgroundChina has a large population of children under 18 years of age, whose health is of great concern to the Chinese health care system. However, few studies have been conducted to analyze the factors associated with children’s unnecessary health care utilization in China. The objective of this study is to provide some empirical evidence on this issue by investigating the role of parental health care utilization in children’s unnecessary health care use.MethodsThe data were obtained from the fifth Health Service Survey of Shaanxi province in 2013. We employed three dependent variables to measure children’s health care utilization: the number of children’s outpatient visits during the past 2 weeks, whether or not infusion was used if the child had any outpatient visits during the past 2 weeks, and the number of children’s inpatient visits during last year. Based on specific characteristics of these outcome variables, negative binomial models were used for the non-negative numbers of outpatient and inpatient visits, while a probit model was used for the zero-one indicator variable showing whether infusion was used during outpatient visits.ResultsBased on a sample of 11,024 children, our results of multivariate analysis showed that children whose parents used outpatient care were estimated to have a larger number of outpatient visits than those whose parents did not have outpatient visits in the past 2 weeks (with a difference of 0.0393 visits). Among children having outpatient visits in the last 2 weeks, the probability of obtaining infusion was 57.01 percentage points higher for children whose parents used infusion in the past 2 weeks than the probability for those whose parents did not use infusion. The predicted number of inpatient visits was higher for children whose parents used inpatient services in the last year, compared with the group whose parents did not use (with a difference of 0.0567 visits). Moreover, we noted that the positive association between parental and children’s health care use was more prominent among younger children.ConclusionsChinese children whose parents were high health care users were more likely to overuse health care services, holding other factors constant. Parents can play an important role in reducing children’s unnecessary outpatient visits, infusion use, and inpatient visits. The results suggest that interventions aimed at affecting patterns of parental use may be helpful in improving appropriate health care utilization for children.

Consultation prevalence among children, adolescents and young adults with pain conditions: A description of age‐ and gender differences

“…This development with age is reflected in pain assessment, where for children under the age of 6, behavioural pain scales are usually needed to assess pain, whereas for older children pain assessment can be based on self-report and several self-reporting tools are also recommended from the age of 4 (Beltramini, Milojevic, & Pateron, 2017). Studies have reported that parents with poorer health status (Dreyer, Williamson, Hargreaves, Rosen, & Deeny, 2018;Tsao, Evans, Seidman, & Zeltzer, 2011), or who are high healthcare users themselves (Zhang, Zhou, & Si, 2017), were more likely to seek healthcare for their children. This indicates that parents could play an important role in patterns of healthcare consultation.…”

Comparison of Health Care Utilization Among Patients Affiliated and Not Affiliated with Healthcare Professionals in China

“…Our result highlighted strong economic signi cance of supplier-induced demand on outpatient health care expenditure, indicating that patients not a liated with healthcare professionals paid more for unnecessary service and treatment compared with patients a liated with healthcare professionals. Healthcare professionals are often blamed for the high cost of health care services as they are often able to induce patients to consume more health care than necessary [4,30]. For instance, studies in developed countries also have illustrated that physicians tend to perform more cesarean delivery in response to declining fertility, treat more intensively when their incomes are adversely affected by fee-reduction policies, and prescribe more medications to patients [10,[36][37][38].…”

“…Previous studies indicated that the overall level of health literacy among Chinese residents was relatively low [47]. Therefore, health promotion and education may play an important role in patient empowerment, which in turn leads to better self-management of medical conditions, ultimately lowering costs of care [30,47,48].…”

“…The CLDS collected information on outpatient use in the two weeks preceding the survey and inpatient use in one year preceding the survey to measure heath care utilization to avoid the recall bias in retrospective investigation [30]. Therefore, we generated four outcome variables, outpatient rate (0-No, 1-Yes), outpatient expenditure (continuous variable measured by CNY), inpatient rate (0-No, 1-Yes), and inpatient expenditure (continuous variable measured by CNY), for analysis.…”

Comparison of Health Care Utilization Among Patients Affiliated and Not Affiliated with Healthcare Professionals in China

“…The CLDS collected information on outpatient use in the two weeks preceding the survey and inpatient use in one year preceding the survey to measure heath care utilization to avoid the recall bias in retrospective investigation [33]. Therefore, we generated four outcome variables, outpatient rate (0-No, 1-Yes), outpatient expenditure (continuous variable measured by CNY), inpatient rate (0-No, 1-Yes), and inpatient expenditure (continuous variable measured by CNY), for analysis.…”