The New Morbidity: Use of School and Community Health Care Resources for Behavioral, Educational, and Social-Family Problems

PEDIATRICS ◽  
1981 ◽  
Vol 67 (1) ◽  
pp. 53-60
Author(s):  
Philip R. Nader ◽  
Laura Ray ◽  
Susan G. Brink

The extent of the use of services for the new morbidity, that is, children's behavioral, educational, and family-social problems, has not previously been the subject of a community-based prospective study. The demographic characteristics and utilization of school and community health care resources over a two-year period are compared for two groups selected from a random sample (n = 671) of elementary school children. Twentyfour percent (n = 164) were observed to have behavioral, educational, or social-family problems requiring attention or intervention by health or educational personnel. This group was compared to their schoolmates (n = 507) not so identified. Although no overall differences in sex, ethnic background, or family structure were identified, the children with new morbidity problems were more frequently in the lowest socioeconomic group, and had lower reading achievement scores and higher rates of absenteeism. The new morbidity group also had higher rates of utilization of services both at school and at community sites of health care, not only for new morbidity complaints, but for other problems as well. The data suggest that this portion of the school-aged population places a significant demand for health care resources on both community and school sites. The findings support the need for training of physicians in the care and prevention of such problems.

2020 ◽  
pp. 1-25
Author(s):  
Jill-Marit Moholt ◽  
Oddgeir Friborg ◽  
Nils Henriksen ◽  
Torunn Hamran ◽  
Bodil H. Blix

Abstract Community health-care services for older, home-dwelling persons with dementia tend to be underutilised. Family care-givers provide substantial care, and they often arrange for and co-ordinate health-care services on behalf of persons with dementia. The aim of this study was to examine family care-givers’ knowledge of unused services and their self-reported reasons for non-use of such services. We gathered cross-sectional survey data from 430 family care-givers of older persons with dementia in Northern Norway. Multinomial logistic regression analysis was used to identify predictors of family care-givers’ knowledge of unused services. An open-ended question regarding reasons for non-use of services was analysed by thematic text analysis. Characteristics of family care-givers (e.g. education level) and factors related to the care-giving circumstances (e.g. negative impact of care-giving) predicted family care-givers’ knowledge of unused services. Reasons for non-use of services were multifaceted and complex, and were related to attributes of the person with dementia and/or the family care-giver (e.g. reluctance to use services) and/or the health-care services (e.g. low quality). Although services were unused, several family care-givers indicated substantial needs for the services. Strategies aimed at addressing the non-use of services should emphasise individuals’ and families’ needs and the adaptation of information about available services and their benefits for both care recipients and family care-givers. A relationship-centred care approach is thus recommended in dementia care.


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