Date of Award
2006
Degree Type
Thesis
Degree Name
Master of Science
Program
Epidemiology and Biostatistics
Supervisor
Dr. M. Karen Campbell
Second Advisor
Dr. Orlando da Silva
Third Advisor
Dr. Tom Freeman
Abstract
Objectives.- To describe maternal and infant health services utilization (HSU), to investigate determinants of infant HSU, to test the hypothesis that maternal depression and anxiety influence infant HSU, and to investigate unmet health care needs. Methods: A cross-sectional follow-up of the Prenatal Health Project cohort was conducted by telephone interviews with mothers of 655 infants aged 2-12 months. Using the Andersen Behavioral Model as a framework, multivariable linear regressions of infant primary care provider (PCP) visits and logistic regressions of infant emergency room (ER) and walk-in clinic (WIC) utilization were performed. Exploratory analyses were conducted to investigate the relationships between mothers’ and infants’ HSU. Results: A response rate of 75% was achieved. The mean number of PCP visits per month for infants <6 months was 1.27 and 0.77 for infants 6-12 months. 25% of infants had visited the ER since birth and 24% of infants had visited a WIC. Mothers had a mean number of 1.86 family physician visits, 10% visited the ER and 15% visited the WIC since their infant’s birth. No associations were found between infants’ HSU and maternal depressive symptoms or anxiety. Number of PCP visits for infants <6 months was positively associated with small for gestational age (SGA) and preterm birth and negatively associated with infant age. No variables were associated with PCP visits for infants > 6 months of age. ER use was positively associated with infant age, access difficulties and unmarried mother. WIC use was positively associated with infant age, SGA, access difficulties and unmarried mother, and negatively associated with less maternal education. Mothers’ HSU was positively associated with infant PCP visits and WIC utilization. Fewer than 1% of mothers had perceived unmet health care needs related to their infant but 13% of mothers reported access difficulties and 10% desired additional health services. Conclusion: Infants utilize a wide range of health services in the first year of life. Predisposing characteristics, including maternal mental health, were not important determinants of infants’ HSU. Enabling resources and need factors were found to be more important determinants of infants’ HSU.
Recommended Citation
Anderson, Laura Nicole, "INFANT HEALTH SERVICES UTILIZATION AND UNMET HEALTH CARE NEEDS" (2006). Digitized Theses. 4944.
https://ir.lib.uwo.ca/digitizedtheses/4944