Vulnerable children: parents' perspectives and the use of medical care.

In a study of use of five general pediatric services, 750 parents were interviewed on site about their decisions on how and when to seek medical care for their children. Parents' fears that a particular child was "vulnerable"--ie, uniquely threatened by an episode of illness--was a recurrent concern (reported by 27%), explaining many of their medical visits. Medical record review indicated that in 40%, there was no clinical basis for these parent concerns. One important source of these unwarranted concerns was fear of recurrence of an earlier medical problem, long since resolved. In some families, the role of social and environmental issues in generating a high level of concern was evident. Vulnerable children made more visits per year and made many more of their visits to the emergency room, and their parents more often expressed dissatisfaction with care received. Recognition of reasons underlying parents' sense of the child's special status may do much to allay unnecessary fears and promote more appropriate use of health care facilities.