Characteristics of children with high and low usage of physician services.

This study examines utilization of physician services using a sample of 17,110 children younger than 18 years from the Child Health Supplement to the 1988 National Health Interview Survey on Child Health. Although children averaged 3 contacts with physicians, 21% of children did not use physician services and 7% had 10 or more contacts and accounted for 37% of all contacts for children during 1988. Age and ethnicity of the child; family income, health insurance status, size, and area of residence; and mother's educational attainment were important sociodemographic correlates of low usage. In contrast, demographic and socioeconomic characteristics were found to be only modest predictors of high usage. Children's health characteristics, especially number of childhood health conditions, were highly predictive of both high and low physician services usage. Compared with children who had no reported conditions, children with multiple conditions were eight times as likely to be high users and were only a fourth as likely to be low users. Implications of these results are discussed.