Social marginalization reduces use of ENT physicians in primary care

Int J Pediatr Otorhinolaryngol. 2012 Mar;76(3):370-3. doi: 10.1016/j.ijporl.2011.12.011. Epub 2012 Jan 5.


Objective: The aim of this study was to explore the association between social marginalization of the mothers and their children's use of the healthcare system and ear-nose-throat (ENT) physicians in the year 2009 in a region of Denmark.

Methods: A regional register-based cross-sectional study of use of healthcare services among children (n=10,232) of marginalized mothers and children (n=101,582) of non-marginalized mothers in the North Denmark Region. Social marginalization was defined as having received public social benefits for more than 80% of the year.

Results: Children with a marginalized mother had more chronic medical diagnoses (OR=1.22, 95% confidence interval 1.17-1.28), they had more frequently been in contact with their general practitioner during the year, and they used the healthcare system more often than children of non-marginalized mothers, except in the case of ENT specialists (OR=0.90, 0.85-0.95), and they had more seldom tympanostomy tubes inserted (OR=0.75, 0.66-0.87). The distance between ENT-clinic and place of residence of the patients had only a small effect on the use of ENT-physician, and only significant in the non-marginalized.

Conclusions: Children of marginalized mothers used the healthcare system more than other children, except in case of ENT-physicians. They had fewer ENT-consultations and had less frequently inserted tympanostomy tubes when they attended the surgery.

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Denmark
  • Female
  • Health Services / statistics & numerical data*
  • Health Services Accessibility
  • Health Status Disparities
  • Humans
  • Infant
  • Male
  • Mothers*
  • Otolaryngology*
  • Primary Health Care / statistics & numerical data*
  • Social Class*
  • Socioeconomic Factors