This is a retrospective longitudinal study of health service utilization using the Immunization Practice Data Set obtained from the Center for Pediatric Research, Norfolk, Virginia. Cluster sampling was used to identify a cohort of children (n = 271), aged 0 to 24 months, from the city of Norfolk, Virginia. A two-year abstraction of medical records was used to determine utilization practice patterns for three categories of health: well-baby, acute and chronic care. The purpose of this study was to identify socio-demographic, need, and health system factors associated with under-utilization of primary care services using Aday's model. The proportion of children who met the American Academy of Pediatrics guidelines for the number of preventive care visits was identified.
As a group, half of the children in the first year-of-life failed to meet the AAP guidelines of 5 well-baby visits (mean = 4.64, SD 2.72) while most of those in the second year-of-life slightly exceeded the 3 well-baby visit standard (mean = 4.04, SD 2.47). Compliance in the latter group was 76.60 of the cohort (n = 82) and those that did not meet the AAP specification were 23.4% (n = 25). The mean age of the child at first visit was 8.1 months and represents a highly significant lack of well baby/preventive care visits during the first year of life in the study cohort.
Results of this study concur with prior research in identifying risk factors/variables associated with access to healthcare providers and under utilization of primary care providers. Respondents who tended to under-utilize primary care services and over utilize emergency care providers were Black, single unsupported parents, from low-income families, with low education and those who lacked insurance. The major barriers reported by parents were location, lack of transportation, and cost.
","abstract_html":"<p>This is a retrospective longitudinal study of health service utilization using the Immunization Practice Data Set obtained from the Center for Pediatric Research, Norfolk, Virginia. Cluster sampling was used to identify a cohort of children (n = 271), aged 0 to 24 months, from the city of Norfolk, Virginia. A two-year abstraction of medical records was used to determine utilization practice patterns for three categories of health: well-baby, acute and chronic care. The purpose of this study was to identify socio-demographic, need, and health system factors associated with under-utilization of primary care services using Aday's model. The proportion of children who met the American Academy of Pediatrics guidelines for the number of preventive care visits was identified.</p> <p>As a group, half of the children in the first year-of-life failed to meet the AAP guidelines of 5 well-baby visits (mean = 4.64, SD 2.72) while most of those in the second year-of-life slightly exceeded the 3 well-baby visit standard (mean = 4.04, SD 2.47). Compliance in the latter group was 76.60 of the cohort (n = 82) and those that did not meet the AAP specification were 23.4% (n = 25). The mean age of the child at first visit was 8.1 months and represents a highly significant lack of well baby/preventive care visits during the first year of life in the study cohort.</p> <p>Results of this study concur with prior research in identifying risk factors/variables associated with access to healthcare providers and under utilization of primary care providers. Respondents who tended to under-utilize primary care services and over utilize emergency care providers were Black, single unsupported parents, from low-income families, with low education and those who lacked insurance. The major barriers reported by parents were location, lack of transportation, and cost.</p>","abstract_has_math":false,"creators":["Waibel, Ruth A."],"institution":null,"degree_name":"Doctor of Philosophy (PhD)","degree_level":"Dissertation","degree_discipline":null,"degree_department":null,"school":null,"contributors":["Clare Houseman","Ardythe L. Morrow","Katharine C. Kersey"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2001,"date_issued":"2001-07-01T07:00:00Z","date_published":"2001-07-01T07:00:00Z","updated_at":"2026-07-24T03:35:30Z","subjects":["Children","Health care utilization","Infants","Primary health care","Primary Care","Public Health"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://digitalcommons.odu.edu/healthservices_etds/83","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Clare Houseman","Ardythe L. Morrow","Katharine C. Kersey"]},{"key":"dc:creator","label":"Author","values":["Waibel, Ruth A."]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.available","label":"Dc Date Available","values":["2019-11-01T07:00:00Z"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Dissertation"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Doctor of Philosophy (PhD)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Children","Health care utilization","Infants","Primary health care","Primary Care","Public Health"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://digitalcommons.odu.edu/healthservices_etds/83"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["This is a retrospective longitudinal study of health service utilization using the Immunization Practice Data Set obtained from the Center for Pediatric Research, Norfolk, Virginia. Cluster sampling was used to identify a cohort of children (n = 271), aged 0 to 24 months, from the city of Norfolk, Virginia. A two-year abstraction of medical records was used to determine utilization practice patterns for three categories of health: well-baby, acute and chronic care. The purpose of this study was to identify socio-demographic, need, and health system factors associated with under-utilization of primary care services using Aday's model. The proportion of children who met the American Academy of Pediatrics guidelines for the number of preventive care visits was identified.
As a group, half of the children in the first year-of-life failed to meet the AAP guidelines of 5 well-baby visits (mean = 4.64, SD 2.72) while most of those in the second year-of-life slightly exceeded the 3 well-baby visit standard (mean = 4.04, SD 2.47). Compliance in the latter group was 76.60 of the cohort (n = 82) and those that did not meet the AAP specification were 23.4% (n = 25). The mean age of the child at first visit was 8.1 months and represents a highly significant lack of well baby/preventive care visits during the first year of life in the study cohort.
Results of this study concur with prior research in identifying risk factors/variables associated with access to healthcare providers and under utilization of primary care providers. Respondents who tended to under-utilize primary care services and over utilize emergency care providers were Black, single unsupported parents, from low-income families, with low education and those who lacked insurance. The major barriers reported by parents were location, lack of transportation, and cost.
"]},{"key":"dc:title","label":"Title","values":["Barrier to Utilization of Primary Healthcare Resources in Children Two Years of Age and Under"]}]}],"canonical_facts":{"dc:contributor":["Clare Houseman","Ardythe L. Morrow","Katharine C. Kersey"],"dc:creator":["Waibel, Ruth A."],"dc:date.available":["2019-11-01T07:00:00Z"],"dc:description.abstract":["This is a retrospective longitudinal study of health service utilization using the Immunization Practice Data Set obtained from the Center for Pediatric Research, Norfolk, Virginia. Cluster sampling was used to identify a cohort of children (n = 271), aged 0 to 24 months, from the city of Norfolk, Virginia. A two-year abstraction of medical records was used to determine utilization practice patterns for three categories of health: well-baby, acute and chronic care. The purpose of this study was to identify socio-demographic, need, and health system factors associated with under-utilization of primary care services using Aday's model. The proportion of children who met the American Academy of Pediatrics guidelines for the number of preventive care visits was identified.
As a group, half of the children in the first year-of-life failed to meet the AAP guidelines of 5 well-baby visits (mean = 4.64, SD 2.72) while most of those in the second year-of-life slightly exceeded the 3 well-baby visit standard (mean = 4.04, SD 2.47). Compliance in the latter group was 76.60 of the cohort (n = 82) and those that did not meet the AAP specification were 23.4% (n = 25). The mean age of the child at first visit was 8.1 months and represents a highly significant lack of well baby/preventive care visits during the first year of life in the study cohort.
Results of this study concur with prior research in identifying risk factors/variables associated with access to healthcare providers and under utilization of primary care providers. Respondents who tended to under-utilize primary care services and over utilize emergency care providers were Black, single unsupported parents, from low-income families, with low education and those who lacked insurance. The major barriers reported by parents were location, lack of transportation, and cost.
"],"dc:identifier":["https://digitalcommons.odu.edu/healthservices_etds/83"],"dc:subject":["Children","Health care utilization","Infants","Primary health care","Primary Care","Public Health"],"dc:title":["Barrier to Utilization of Primary Healthcare Resources in Children Two Years of Age and Under"],"thesis:degree_level":["Dissertation"],"thesis:degree_name":["Doctor of Philosophy (PhD)"]},"updated_at":"2026-07-24T03:35:30Z"}