The relationship between grandmothers' involvement in child care and emergency department utilization.

This study examines the relationship between involvement of grandmothers in child care and poor urban mothers' use of the emergency department (ED) for nonurgent care. Mothers with an index child between one and two years old were interviewed in the waiting room of a pediatric continuity clinic. They were asked about the proximity and involvement in child care of a grandmother, great-grandmother, or female family member. Frequency of ED use was abstracted from the index child's medical records. Results showed that mothers who frequently used the ED for nonemergent pediatric care were more likely to have the child's grandmother or great-grandmother living in close proximity or involved in care of the child than infrequent users (80 vs 45%, P < 0.05). This study suggests that proximity and involvement of the grandmother may influence health care decisions.