Children's use of general practitioner services in the five Nordic countries

Objective: To compare socioeconomic, sociodemographic, and living area differences in children's use of GP services in five Nordic countries from the 1980s to the 1990s and to analyse trends during the period. Design: Cross sectional population surveys using random samples comprising 3000 children aged 2 - 17 years were conducted in 1984 and 1996 in five Nordic countries. Time trends in use of GP services were studied in each country by age, sex, parents' highest level of education, and living area. Setting: Five Nordic countries, Denmark, Finland, Iceland, Norway, and Sweden in 1984 and 1996. Participants: A total sample of 15 000 children aged 2 - 17 years. Altogether 3000 children were selected at random from the national population registers of the national bureaus of statistics in each country. Main outcome: Health services utilisation on the basis of responses to a questionnaire item asking whether the parents had consulted a GP with regard to their children's health during the previous three months. Main results: The prevalence of children's utilisation of GP services varied from 14% in 1984 in Sweden to 28% in 1996 in Iceland. A clear time trend towards increasing utilisation of GP services (p < 0.05) was found in all countries except in Denmark. Odds ratios for time trends (1984 = 1.00) varied from 1.22 (1.02 to 1.46) in Sweden to 1.92 (1.62 to 2.30) in Norway. After adjusting for independent variables, a statistically borderline significant declining utilisation trend (OR = 0.85 (0.70 to 1.03)) was found for Denmark. Conclusion: Children's use of GP services has increased significantly in four of the five Nordic countries.