Gastrointestinal symptoms and use of medical care associated with child day care and health care plan among preschool children

Objectives. This study examined whether out-of-home day care increases the risk of gastrointestinal symptoms for children <6 years of age and whether there is an association between gastrointestinal symptoms and medical care utilization. Methods. The study population comprised members of 2 health plans residing in 2 South Carolina counties: 417 families from an health maintenance organ ization (HMO) plan; and 643 families from a Medicaid plan. Participants wer e followed for 18 months by either bimonthly telephone interviews or person al interviews. The survey/interview collected familial, personal, day-care and disease-related information and medical care utilization, The analyses controlled for both family characteristics and the type of health care plan . Results. Children attending out-of-home day care had higher incidence rates for most gastrointestinal symptoms studied than did children staying at ho me (2.51 vs. 1.61 episodes of mild gastrointestinal symptoms and 1.63 vs. 1 .08 episodes of moderate gastrointestinal symptoms for the HMO group; 1.72 vs. 1.28 episodes of moderate gastrointestinal symptoms for the Medicaid gr oup). Nearly one-fourth of the annual physician visits by children younger than 6 years were attributed to gastrointestinal symptoms, and more than on e-fourth of the children with gastro-intestinal symptoms were prescribed an tibiotics. When displaying gastrointestinal symptoms, children in the Medic aid group were significantly more likely to visit a doctor and receive anti biotics than those in the HMO group. Conclusions, Although the type of health plan has negligible influence on t he frequency of reported gastrointestinal symptoms, it exerts a strong infl uence on medical care utilization.