Original Article

International Journal of Public Health

, Volume 58, Issue 2, pp 207-215

First online:

Predictors of the use of healthcare services in children and adolescents in Spain

  • Jorge-A Palacio-VieiraAffiliated withCatalan Agency for Pulic Health
  • , Ester Villalonga-OlivesAffiliated withIMIM, Institut d’Investigació Hospital del Mar
  • , Jose María ValderasAffiliated withDepartment of Primary Health Care, University of Oxford
  • , Michael HerdmanAffiliated withInsight Consulting and Research
  • , Jordi AlonsoAffiliated withIMIM, Institut d’Investigació Hospital del MarCIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III
  • , Luis RajmilAffiliated withCatalan Agency for Health Information, Assessment and Quality (AIAQS)IMIM, Institut d’Investigació (IMIM- Parc de Salut Mar)CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III Email author 

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To assess medium to long term predictors of healthcare services use in a population-based sample of children/adolescents in Spain.


A sample of children and adolescents aged 8–18 and their parents were evaluated at baseline (2003) and follow-up (2006). Total use of healthcare services and visits to specialist and dentists at the follow-up were analyzed.


Four hundred fifty-four children/adolescents completed baseline and follow-up assessments (response rate 54 %). 90 % of respondents reported at least one visit during the 12 months previous to the follow-up. Low socioeconomic status (beta coefficient = 0.30; 95 % CI = 0.02–0.57), double healthcare coverage (0.41; 0.17–0.66), parental use of services, poor mental health and activity limitation were associated to the total number of visits. Access to specialist was associated to double healthcare coverage (OR = 1.77; 1.01–3.07) and parental primary level of education (OR = 0.51; 0.32–0.81). Age and low family affluence predicted visits to dentists (OR = 0.38; 0.19–0.73).


No barriers to healthcare services use were found. Family level of education, family affluence and double healthcare coverage predicted the use of specialists and dentists.


Adolescent Equity Follow-up studies Health services use