Abstract
BackgroundApproximately 13% of Canadian mothers report difficulty accessing health care for their infants, yet little is known about the factors associated with difficulty. Therefore, we examined factors associated with difficulty accessing non-routine health care for Canadian infants, from birth to 14 months of age, as reported by their mothers.MethodsData was drawn from the Maternity Experiences Survey (MES), a cross-sectional, nationally representative survey of mothers who gave birth between November 2005 and May 2006, aged 15 years or older, and lived with their infants at the time of survey administration. A multivariable logistic regression analysis was conducted to determine factors associated with reporting difficulty, with difficulty defined as a mother reporting it being somewhat or very difficult to access a health care provider.ResultsAnalysis of 2832 mothers who reported needing to access a health care provider for their infant for a non-routine visit found that 13% reported difficulty accessing a provider. Factors associated with reporting difficulty were: residing in Quebec (aOR 1.89, 95% CI: 1.31–2.73), being an immigrant (aOR 1.58, 95% CI: 1.10–2.27), mistimed pregnancy (aOR 1.44, 95% CI: 1.05–1.98), low level of social support (aOR 1.69, 95% CI: 1.05–2.73), good health (aOR 1.88, 95% CI: 1.43–2.47), postpartum depression symptoms (aOR 1.55, 95% CI: 1.02–2.37) and a self-reported ‘too-short’ postpartum hospital stay (aOR 1.69, 95% CI: 1.21–2.35). Additionally, accessing care for an infant with a birth weight of 2500 g or more (aOR 2.43, 95% CI: 1.02–5.82), was associated with reporting difficulty. Household income, mothers’ level of education, marital status, Aboriginal ethnicity, and size of community of residence were not associated with difficulty accessing care.ConclusionsEase of health care access for Canadian infants is not equal, suggesting that efforts to improve access should be tailored to groups facing increased difficulties.
Highlights
13% of Canadian mothers report difficulty accessing health care for their infants, yet little is known about the factors associated with difficulty
While Canadian infant mortality rate demonstrated a sharp decline between the mid 1960s and 1990s [3], substantial decreases have not been seen since the mid 1990s, resulting in Canada’s fall from 5th to 28th place in infant mortality rankings among the 35 OECD (Organization for Economic Cooperation and Development) countries as of 2012 [4]
After adjustment, one study found that American infants who did not participate in either Medicaid or private insurance were 1.39 times more likely to die from perinatal conditions and 1.46 times more likely to die from non-perinatal conditions, injuries, and infections [5]
Summary
13% of Canadian mothers report difficulty accessing health care for their infants, yet little is known about the factors associated with difficulty. We examined factors associated with difficulty accessing non-routine health care for Canadian infants, from birth to 14 months of age, as reported by their mothers. Unhindered access to health services is of notable importance for infants, as the mortality rate for infants (children under one year of age) is the highest among all childhood age groups in Canada [2]. Primary care physician density has been shown to have an independent inverse association with infant mortality in Canada, the United States, and the European Union [6,7,8], suggesting that easier access to primary care may result in lower infant mortality
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