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Healthcare Utilization for Acute and Chronic Diseases of Young, School-age Children in the Rural and Non-rural Setting

Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina

Daniel P. Krowchuk, MD

Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina

Steven R. Feldman, MD, PhD

Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina

Fabian T. Camacho, MS

Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina

Rajesh Balkrishnan, PhD

Division of Management and Community Health Sciences, University of Texas Schools of Public Health and Medicine, Houston, Texas

Alan B. Fleischer, MD

Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina

To determine the most frequently diagnosed conditions among rural and non-rural children age 5 to 9 and assess for environmental influences, data from the National Ambulatory Medical Care Survey (1996-2001) were used to examine frequencies of diagnoses in children age 5 to 9. Separately, we examined rural and non-rural outpatient physician visits in weighted multivariate logistic regression models. Overall, the most frequent diagnosis was routine health check, followed by several acute conditions. When analyzed separately, non-rural children were significantly more likely to visit a physician for routine health check (P = 0.002), asthma (P = 0.005), and acute upper respiratory infection (P = 0.037). Rural counterparts were significantly more likely to be seen for attention deficit disorder (P = 0.000), otitis media (P = 0.017), chronic rhinitis (P = 0.017) and influenza (P = 0.037). Children age 5 to 9 are healthy overall. When illness occurs, it is usually acute. Rural and non-rural, young, school-aged children exhibit many similarities in healthcare utilization, but differences occur. Most surprising is the difference in the diagnosis frequency of attention deficit disorder.

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