Objective: To examine those factors associated with the use of different ty
pes of ambulatory health services in a rural adolescent population.
Methods: The student bodies of 2 middle schools and 2 high schools in rural
areas in a mid Atlantic state (N=1615) were surveyed using a self-administ
ered health status and health services use instrument. Logistic regression
was used to assess factors predicting receipt of (I) preventive services, (
2) problem-focused services, and (3) emergency services.
Results: One third of the rural youth reported having received preventive s
ervices within the previous 3 months; 41% received problem-focused care, an
d 18% received emergency services. Having the same provider for both preven
tive and illness care tvas the most consistent and significant predictor of
receipt for all types of ambulatory services. Of special note is the great
er use of emergency services when subjects did not have a consistent provid
er for both preventive and illness care. Health need variables, measured ac
ross a wide range of domains, were additionally predictive, and their signi
ficance varied according to the type of services received.
Conclusions: This study provides compelling evidence that for rural adolesc
ents, having a regular source of care and medical need are the most importa
nt predictors of use across a variety of types of ambulatory care.