The influence of migratory background and parental education on health care utilisation of children

Nicole Rosenkotter*, Martien C. J. M. van Dongen, Wolfgang Hellmeier, Klaus Simon, Pieter C. Dagnelie

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


School-entry screening data from North Rhine-Westphalia (NRW), Germany from 2007 were used to investigate child health care utilisation. We focussed on the influence of migratory background and parental education on children's (1) participation in regularly scheduled early recognition examinations, (2) immunisation uptake and (3) referrals due to a school-entry screen-detected complaint. The study sample consisted of 52,171 children out of 17 NRW districts. Bivariable, stratified and multivariable analyses were performed to identify relevant associations between social determinants and health care utilisation outcome parameters. Multivariable logistic regression showed that children belonging to families with a migratory background or low parental education were more likely to have an incomplete documentation of early recognition examinations and to be referred due to a new diagnosis. Children with migratory background were more likely to be sufficiently immunised than children with parents of German ethnicity. For all studied health care utilisation outcomes, kindergarten visit had a supportive effect. Conclusion: In general, the results of our regional study were in line with the results from national population-based studies. Additionally, a larger likelihood of referrals due to school-screen-detected deficits in children with migratory background or low parental education was detected.
Original languageEnglish
Pages (from-to)1533-1540
JournalEuropean Journal of Pediatrics
Issue number10
Publication statusPublished - Oct 2012


  • Child health
  • Health service usage
  • Migration and health
  • Social differences

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