Morbidity and healthcare utilisation of children in households with one adult: comparative observational study

Objective: To identify and consider differences in morbidity in children in households with one adult presenting to general practitioners compared with children in households with more than one adult. Design: Observational study; data analysed with logistic regression controlling for age, sex, and practice. Subjects: 93 356 children aged 0-15 years included in the fourth national study of morbidity in general practice and for whom data about household structure were available. Among them 10 983 (11.8%) were living in households with a sole adult. Methods: Morbidity data were recorded from each consultation as the assessment diagnosis made by the general practitioner. Main outcome measures: Number of consultations and consultations per person for any illness, infections, acute respiratory infections, asthma, and accidents; number presenting and mean consultations per person for immunisation; number receiving home visits and home visits per person visited; average annual frequency of consultation among those consulting. Results: Compared with children in other households, a higher proportion of children in households with one adult consulted for infections and accidents. The proportion consulting for immunisation was lower and the proportion receiving home visits greater. Mean numbers of consultations per person consulting were also generally higher for all conditions. For infections, accidents, and home visits, the differences were evident in all age groups. Conclusions: The study confirms the importance of single parent families as an indicator of deprivation. Children in such families should be targeted for immunisation and accident prevention.