Tessler R
Health Serv Res. 1980 Spring;15(1):55-62.
The purpose of this study is to separate out the effects of number of siblings and birth order on children's use of physician services. Prior research has consistently revealed an inverse relationship between family size and physician visits, but the possible confounding influence of the child's ordinal position in the family has been ignored. Later born children may be taken to the doctor less often than first and other early borns because of their parents' increasing knowledgeability in regard to child care as well as their growing understanding of the uses and limitations of physician visits. On the assumption that part of the family size effect observed in prior research may have been due to the clustering of first and early borns in small families, an inverse relationship between birth order and physician utilization is hypothesized. Support for this hypothesis comes from an empirical study of 1,665 children from 587 families in which variation in family size is statistically controlled.
本研究的目的是区分兄弟姐妹数量和出生顺序对儿童使用医生服务的影响。先前的研究一直揭示家庭规模与看医生次数之间存在反比关系，但儿童在家庭中的排行位置可能产生的混杂影响却被忽视了。由于父母在育儿方面知识日益丰富，以及对看医生的作用和局限性有了更多了解，后出生的孩子看医生的次数可能比第一个及其他早出生的孩子少。假设先前研究中观察到的部分家庭规模效应可能是由于小家庭中头胎和早出生孩子的聚集，那么可以假设出生顺序与医生服务利用率之间存在反比关系。对这一假设的支持来自对587个家庭的1665名儿童的实证研究，其中家庭规模的差异在统计上得到了控制。
