Children outpatient health care utilization was estimated by a cross-sectional household survey using multi-stage cluster sampling in the city of São Luís, in the State of Maranhão, Brazil. 711 mothers or caretakers of children aged from 3 to 59 months answered a standardized questionnaire. The aim was to study factors associated with non-consultation and verify if the National Health Service (SUS) implementation and public outpatient care expansion reduced inequality in the use of health services. More than two thirds, 67.2% of the children, had been seen by a physician when sick in the previous trimester. The National Health Service funded 74.9% of the services. A low percentage, 0.7%, did not get an appointment, indicating that very few cases remained unattended to. After adjustment for confounding factors by means of the Cox proportional hazards model modified for cross-sectional design, predisposing factors, i.e. maternal education, child age and gender, maternal age, number of siblings, and head of household's occupation explained little of the non-consultation rate. Enabling factors, i.e. family income and health insurance did not predict non-consultation. The main predictor for not having an appointment was not needing medical care, because healthy children were at a greater risk of not visiting a doctor.
Health services research; Referral and consultation; Social inequity; Health services research; Child, preschool
