Chen Alex Y, Escarce José J
Department of Pediatrics, Division of Research on Children, Youth, and Families, Children's Hospital Los Angeles, 4650 Sunset Blvd. MS #30, Los Angeles, CA 90027, USA.
Health Serv Res. 2006 Oct;41(5):1895-914. doi: 10.1111/j.1475-6773.2006.00584.x.
To examine the effects of family structure, including number of parents, number of other children, and number and type of other adults, on office visits, emergency room visits, and use of prescription medications by children.
The Household Component of the 1996-2001 Medical Expenditure Panel Survey (MEPS).
The study consisted of a nationally representative sample of children 0-17 years of age living in single-mother or two-parent families. We used negative binomial regression to model office visits and emergency room visits and logistic regression to model the likelihood of prescription medication use. Our analyses adjusted for demographic and socioeconomic characteristics as well as measures of children's health and parental education and child-rearing experience.
DATA COLLECTION/EXTRACTION METHOD: We combined 1996-2001 MEPS Full Year Consolidated Files and Medical Conditions Files.
Descriptive data showed that children in single-mother families had fewer office visits than children in two-parent families; however, the effect of number of parents in the family on children's office visits or use of prescription medications was completely explained by other explanatory variables. By contrast, children living in families with many other children had fewer total and physician office visits and a lower likelihood of using a prescription medication than children living in families with no other children even after adjusting for other explanatory variables. Children who lived with other adults in addition to their parents also had fewer office visits and a lower likelihood of using a prescription medication than children who lived only with their parents.
Children living in families with many other children or with other adults use less ambulatory care and prescription medications than their peers. Additional research is needed to determine whether these differences in utilization affect children's health.
研究家庭结构，包括父母数量、其他子女数量以及其他成年人的数量和类型，对儿童门诊就诊、急诊就诊及处方药使用情况的影响。
1996 - 2001年医疗支出面板调查（MEPS）的家庭部分。
该研究包括一个具有全国代表性的0至17岁儿童样本，这些儿童生活在单亲家庭或双亲家庭中。我们使用负二项回归对门诊就诊和急诊就诊进行建模，并使用逻辑回归对使用处方药的可能性进行建模。我们的分析对人口统计学和社会经济特征以及儿童健康指标、父母教育程度和育儿经验进行了调整。
数据收集/提取方法：我们合并了1996 - 2001年MEPS全年综合文件和医疗状况文件。
描述性数据显示，单亲家庭中的儿童门诊就诊次数少于双亲家庭中的儿童；然而，家庭中父母数量对儿童门诊就诊或处方药使用的影响完全由其他解释变量所解释。相比之下，即使在对其他解释变量进行调整之后，与没有其他子女的家庭中的儿童相比，生活在有许多其他子女家庭中的儿童的总就诊次数和医生门诊就诊次数更少，使用处方药的可能性也更低。除父母外还与其他成年人一起生活的儿童的门诊就诊次数和使用处方药的可能性也低于仅与父母生活的儿童。
与同龄人相比，生活在有许多其他子女或其他成年人家庭中的儿童使用的门诊医疗服务和处方药较少。需要进一步研究以确定这些使用差异是否会影响儿童健康。
