Predictors of health care utilization in young children with recurrent pain – a population-based study

Background: Recurrent pain is a common experience in childhood, but only few children with recurrent pain attend a physician. Previous small-scale studies yielded conflicting findings with regard to predictors of health care utilization in children with recurrent pain. Methods: The present study analyzes a subset of the data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study. Specifically, our sample comprised n= 2,149 young children (3-10 years old) with recurrent pain to find robust predictors. We used multiple logistic regressions to investigate age, gender, SES, migration background, pain intensity, pain frequency, pain-related disability, somatic symptoms, HRQL, as predictors for visiting a doctor due to pain. Additionally we investigated the variability of the predictors to assess the sample size needed to make reliable claims about predictors of health-care utilization. Results: Overall, 1144 (53%) children consulted a physician due to recurrent pain. Young girls with high pain-related disability, -intensity, –frequency, and migration background were more likely to attend a physician. Pain-related disability had the largest impact. Socioeconomic status, health-related quality of life and somatic symptoms were not systematically related to health care utilization. An analysis of the variability of these results indicated that several hundred participants are needed until the results stabilize. Conclusions: Our findings highlight the importance of pain-related disability and frequency in assessing the severity of recurrent pain. Generic predictors and demographic variables are of lesser relevance to children with recurrent pain. On a methodological level our results show that large-scale population-based studies are need to reliably identify predictors of health care utilization.