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Teenagers' Self-reported Use of Services and Perceived Access to Confidential Care

Jonathan D. Klein, MD, MPH; Molly McNulty, JD; Claudia N. Flatau, MPH

Arch Pediatr Adolesc Med. 1998;152:676-682.

Background  Most surveys on adolescents' use of health services rely on parental report, and this may underestimate adolescents' use of confidential services.

Objective  To investigate adolescents' report of their own use of health services, access to care, and knowledge and use of confidential services.

Method  A random digit-dialed survey of 14- to 19-year-old adolescents was conducted in Monroe County, New York. We screened 11800 numbers and identified 4449 households (40%) of which 393 families (8.8%) had eligible adolescents. Of these, 259 (66%) consented and completed an interviewer-administered survey.

Results  Almost all adolescents (92%) rated their health as excellent or good and 90% had visited a health care provider within the year. Most (88%) identified a source of primary care. As many as 27% of adolescents had used more than one source of care. Many youth identify school personnel as important resources for health and counseling needs. Only 8.4% of respondents have used services confidentially, but nearly half of all youth did not know where they could obtain confidential care if they needed to. Adolescents were least likely to know where to obtain mental health or substance abuse and reproductive services.

Conclusions  While most youth have used primary care, a substantial minority have not. Many teenagers depend on multiple sources of care, and they rely on school personnel as important sources of health information. Many do not know where they could go to review confidential services or for other services that they may need. Managed care insurance and public health policies should recognize adolescents' access needs to meet them appropriately.

From the Division of Adolescent Medicine, Strong Children's Research Center, University of Rochester Medical Center, Rochester, NY.

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