Social and family-related correlates of medical care utilization by asthmatic children in Upper Silesia, Poland

Background: Studies on childhood asthma demonstrate socioeconomic disparities in medical care utilization. A lack of information for Poland prompted our investigation into this question. Its goal was to discover if the utilization of medical services by asthmatic children depends on social and family factors. Methods: Subjects were 186 children with physician-diagnosed asthma, identified through a questionnaire survey of 4,535 school children in Katowice District, Poland. Utilization of medical care was assessed by such past year events as medical visits (44.0%), any diagnostic test (35.4%) and spirometry (30.6%). Association of those events with socioeconomic variables was explored by means of logistic regression, according to the criterion p≤ 0.1. Results: After adjustment for disease severity and gender medical visits were related to younger age (p=0.009), family history of respiratory diseases (p=0.08) and rural residence (p=0.09), any diagnostic tests to younger age (p=0.08), smaller number of siblings (p=0.01) and rural residence (p=0.004); spirometry to smaller number of siblings (p=0.09) and rural residence (p=0.006). Conclusion: Clinical status and age are important determinants of utilization of medical services by asthmatic children. The effects of rural residence and family size may reflect a more attentive response to the needs of a sick child.