Factors associated with difficulty accessing health care for infants in Canada: mothers' reports from the cross-sectional Maternity Experiences Survey

Background: Approximately 13% of Canadian mothers report difficulty accessing health care for their infants, yet little is known about the factors associated with difficulty. Therefore, we examined factors associated with difficulty accessing non-routine health care for Canadian infants, from birth to 14 months of age, as reported by their mothers. Methods: Data was drawn from the Maternity Experiences Survey (MES), a cross-sectional, nationally representative survey of mothers who gave birth between November 2005 and May 2006, aged 15 years or older, and lived with their infants at the time of survey administration. A multivariable logistic regression analysis was conducted to determine factors associated with reporting difficulty, with difficulty defined as a mother reporting it being somewhat or very difficult to access a health care provider. Results: Analysis of 2832 mothers who reported needing to access a health care provider for their infant for a non-routine visit found that 13% reported difficulty accessing a provider. Factors associated with reporting difficulty were: residing in Quebec (aOR 1.89, 95% CI: 1.31-2.73), being an immigrant (aOR 1.58, 95% CI: 1.10-2.27), mistimed pregnancy (aOR 1.44, 95% CI: 1.05-1.98), low level of social support (aOR 1.69, 95% CI: 1.05-2.73), good health (aOR 1.88, 95% CI: 1.43-2.47), postpartum depression symptoms (aOR 1.55, 95% CI: 1.02-2.37) and a self-reported `too-short' postpartum hospital stay (aOR 1.69, 95% CI: 1.21-2.35). Additionally, accessing care for an infant with a birth weight of 2500 g or more (aOR 2.43, 95% CI: 1.02-5.82), was associated with reporting difficulty. Household income, mothers' level of education, marital status, Aboriginal ethnicity, and size of community of residence were not associated with difficulty accessing care. Conclusions: Ease of health care access for Canadian infants is not equal, suggesting that efforts to improve access should be tailored to groups facing increased difficulties.