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Open Access Research article

Understanding adolescent and young adult use of family physician services: a cross-sectional analysis of the Canadian Community Health Survey

Bridget L Ryan1*, Moira Stewart2, M Karen Campbell3, John Koval4 and Amardeep Thind56

Author Affiliations

1 Post-Doctoral Fellow, Suite 245 - 100 Collip Circle, Centre for Studies in Family Medicine, The University of Western Ontario, London, Ontario, N6G 4X8 Canada

2 Director, Suite 245 - 100 Collip Circle, Centre for Studies in Family Medicine, The University of Western Ontario, London, Ontario, N6G 4X8 Canada

3 Chair, K201B Kresge Building, Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, N6A 5C1 Canada

4 Professor, K3D Kresge Building, Department of Epidemiology and Biostatistics, The University of Western Ontario, London, N6A 5C1 Ontario, Canada

5 Associate Professor, Department of Epidemiology and Biostatistics Suite 245 - 100 Collip Circle, Centre for Studies in Family Medicine, The University of Western Ontario, London, Ontario, N6G 4X8 Canada

6 Department of Family Medicine, Suite 245 - 100 Collip Circle, Centre for Studies in Family Medicine, The University of Western Ontario, London, Ontario, N6G 4X8 Canada

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BMC Family Practice 2011, 12:118  doi:10.1186/1471-2296-12-118

Published: 1 November 2011

Abstract

Background

Primary health care is known to have positive effects on population health and may reduce at-risk behavior and health problems in adolescence. Yet little is known about the factors that are associated with adolescent and young adult utilization of family physician services. It is critical to determine the factors associated with utilization to inform effective primary health care policy. We address this gap in the primary health care literature by examining three issues concerning adolescent and young adult family physician use: inequity; the unique developmental stage of adolescence; and the distinction between utilization (users versus non-users) and intensity (high users versus low users).

Methods

We conducted nested logistic regressions for two outcomes: utilization and intensity of family physician services for early adolescence, middle adolescence, and young adulthood using the 2005 Canadian Community Health Survey.

Results

Chronic conditions were associated with utilization in early and middle adolescence and intensity in all age groups. Respondents from Quebec had lower odds of utilization. Those without a regular medical doctor had much lower odds of being users. The factors associated with use in early and middle adolescence were in keeping with parental involvement while the factors in young adulthood show the emerging independence of this group.

Conclusions

We highlight key messages not known previously for adolescent and young adult use of family physician services. There is inequity concerning regional variation and for those who do not have a regular medical doctor. There is variation in factors associated with family physician services across the three age groups of adolescence. Health care and health care policies aimed at younger adolescents must consider that parents are still the primary decision-maker while older adolescents are more autonomous. There is variation in the factors associated with the two outcomes of utilization and intensity of services. Factors associated with utilization must be understood when considering the equitability of access to primary health care while factors associated with intensity must be understood when considering appropriate use of resources. The understanding gained from this study can inform health care policy that is responsive to the critical developmental stage of adolescence and young adulthood.