Increased health care utilization associated with child day care among health maintenance organization and Medicaid enrollees

Abstract

ABSTRACTObjective This study examined the association between child day care and the utilization of health care resources. It also investigated whether increased use of health care resources in day‐care children is due to acute diarrheal illness or upper respiratory tract infections (URI).Sample Study subjects were recruited as day‐care children (n = 435) and home‐care children (n = 753) through a health maintenance organization (HMO) and a consortium of Medicaid providers in Columbia, South Carolina, and were followed bimonthly for 18 months.Method A survey was conducted to collect data on children aged 5 years or younger from their parents. The questionnaires collected familial information, individual characteristics, disease‐related symptoms, and the information on physician visits, antibiotic use, and use of other medicines. The association between day care attendance and the likelihood of using health care resources was examined by multivariate logistic regression analyses.Results Compared with home‐care children, the odds ratios for physician visits, use of antibiotics, and use of other medicines were all significantly greater for children attending day care. However, the increased likelihood of physician visits in day‐care children may not be attributable to diarrheal illness or URI.Conclusions Day care attendance is associated with the increased use of health care. Antibiotics are more likely to be prescribed in day‐care children than in home‐care children for diarrheal illness and URI.Implications for practice Understanding the association between child day care attendance and utilization of health care resources will assist health care providers in evaluating their practice in providing medical care to children.