Correlates of physician visits among children and adolescents in West Texas: Effects of hyperglycemia symptoms

Context: Health care services use by children varies tremendously. Because of the increasing prevalence of diabetes in children and adolscents, one of the major concerns is access to physician care among children with diabetes and diabetes symptoms. Purpose: This population-based cross-sectional study examines correlates of physician visit among children and adolescents living in west Texas. Methods: A telephone survey was administered in 2002 to a random sample of households in 106 counties of West Texas. The sample included 5,462 respondents with children aged between 3 and 18 years. Proportional odds ordered logistic regression analysis was used to determine correlates of physician visits in the previous 12 months. Findings: Hispanic children were less likely than non-Hispanic whites to have a recent physician visit; there were no significant rural-urban differences. Children with insurance (adjusted odds ratio = 2.21, 95% CI = 1.89-2.59) were more likely to visit physicians. Almost 16% of children in this study did not have any health insurance coverage. Children reporting 3 or more hyperglycemia symptoms and those with a family history of diabetes had 1.81 times and 1.20 times the odds of visiting the physician. Conclusions: Presence of health insurance and increasing symptoms of diabetes were found to influence the utilization of physician services. Since most of the cases of diabetes that have recently been diagnosed among Texas youth are type 2 diabetes, it is important that adolescents and their parents are educated about the risk factors and how to recognize them.