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Scandinavian Journal of Public Health
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Impact of user charges and socio-economic environment on visits to paediatric trauma unit in Finland

Jaana Ahlamaa-Tuompo

Helsinki City Hospital, jaana.ahlamaa{at}maaka.inet.fi

Miika Linna

National Agency for Health and Welfare

Martti Kekomäki

Helsinki University Central Hospital, Helsinki; Finland

In this report we (i) measure the strength of the association between paediatric trauma visit rates and regional socioeconomic and demographic variables, and (ii) quantify any selective impact of user charges on service demand in socioeconomically and demographically different areas. During the period 1989—94, a total of 30,362 home and leisure injury visits were made to the Aurora City Hospital. The visit rates are analysed using a random effects model. In addition, the areas are ranked into three groups in accordance with a socioeconomic index measure, and the annual visit rates of the three groups are calculated. We found fairly minor differences in children's visit rates between unequal socioeconomic areas, and it is apparent that socioeconomic status cannot explain the change in visit rates as a result of the introduction of user charges. We speculate that these changes in emergency visit rates will not lead to long-term health problems among any segment of the city population.

Key Words: children • injuries • socioeconomic • user charges.

Scandinavian Journal of Public Health, Vol. 26, No. 4, 265-269 (1998)
DOI: 10.1177/14034948980260040601
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