Health service utilization in the Nordic countries in 1996: Influence of socio-economic factors among children with and without chronic health conditions

BACKGROUND: Previous studies have shown social, economic and psychological factors that influence consulting behaviour, but the health service use of children is seldom studied. METHOD: Data from a cross-sectional study conducted in 1996 including approximately 10,000 children aged 2-17 years in the Nordic countries were analysed according to health service use, measured as consulting a general practitioner (GP) or a specialist during the last three months prior to the survey. RESULTS: Approximately one-fifth of the children in the survey had visited a GP and about one-seventh had visited a specialist. Highest consulting behaviour was found among children with chronic health conditions. Visiting a GP or a specialist varied across the Nordic countries, the pattern depending on disease status. Specialist utilization was higher in towns than in rural areas. Social inequality in the use of specialist, but not GP health services, was present, mainly among children with chronic health conditions. And further, compared to white-collar parents, a higher proportion of working class parents judged specialist health services as important when consulting a doctor because of the child's health problem. CONCLUSION: In all the Nordic countries GP use did not depend on social class, and utilization of specialist health services was mainly unrelated to social class among children without chronic health conditions. Specialist use was associated with high socio-economic status among children with chronic health conditions, despite the observation that a higher proportion of parents in the lower social classes judged specialist health services as important when consulting a doctor.