Morbidity and healthcare utilisation of children in households with one adult: comparative observational study

BMJ 1998;316:1572-1576 ( 23 May )

General Practice

Morbidity and healthcare utilisation of children in households with one adult: comparative observational study

D M Fleming, director, ^a J R H Charlton, statistician. ^b

^a Birmingham Research Unit, Royal College of General Practitioners, Birmingham B17 9DB, ^b Office for National Statistics, London SW1V 2QQ

Correspondence to: Dr Fleming Bill{at}rcgp-bru.demon.co.uk

Objective: To identify and consider differences in morbidity in children in households with one adult presenting togeneral practitioners compared with children in households withmore than one adult.
Design: Observational study; data analysed with logistic regression controlling for age, sex, and practice.
Subjects: 93 356 children aged 0-15 years included in the fourth national study of morbidity in general practice andfor whom data about household structure were available. Amongthem 10 983 (11.8%) were living in households with a sole adult.
Methods: Morbidity data were recorded from each consultation as the assessment diagnosis made by the general practitioner.
Main outcome measures: Number of consultations and consultations per person for any illness, infections, acute respiratoryinfections, asthma, and accidents; number presenting and meanconsultations per person for immunisation; number receiving homevisits and home visits per person visited; average annual frequencyof consultation among those consulting.
Results: Compared with children in other households, a higher proportion of children in households with one adult consultedfor infections and accidents. The proportion consulting for immunisationwas lower and the proportion receiving home visits greater. Meannumbers of consultations per person consulting were also generallyhigher for all conditions. For infections, accidents, and homevisits, the differences were evident in all age groups.
Conclusions: The study confirms the importance of single parent families as an indicator of deprivation. Children insuch families should be targeted for immunisation and accidentprevention.

Key messages

Children in households with one adult consult general practitioners more frequently than those in households with two or more adults and receive increased numbers of home visits
They are more likely to consult for accidents, and they attend less frequently for immunisation
Single parent households are an appropriate indicator of deprivation
Children from households with one adult require specific targeting by general practitioners, health visitors, and primary healthcare workers for accident prevention and immunisation uptake

© BMJ 1998

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