The effects of health insurance and a usual source of care on a child's receipt of health care

Abstract

Introduction: Although recent health care reforms will expand insurance coverage for U.S. children, disparities regarding access to pediatric care persist, even among the insured. We investigated the separate and combined effects of having health insurance and a usual source of care (USC) on children's receipt of health care services.

Methods: We conducted secondary analysis of the nationally representative 2002-2007 Medical Expenditure Panel Survey data from children (≤ 18 years of age) who had at least one health care visit and needed any additional care, tests, or treatment in the preceding year (n = 20,817).

Results: Approximately 88.1% of the study population had both a USC and insurance; 1.1% had neither one; 7.6% had a USC only, and 3.2% had insurance only. Children with both insurance and a USC had the fewest unmet needs. Among insured children, those with no USC had higher rates of unmet needs than did those with a USC.

Discussion: Expansions in health insurance are essential; however, it is also important for every child to have a USC. New models of practice could help to concurrently achieve these goals.

Figure 1. Percentage of US Children Reporting Unmet Healthcare Needs, by Insurance and Usual Source of Care Status

Unmet Med/Dental/Prescription Need = Respondent reported that child was unable to get or had a delay in getting needed medical, dental, or prescription care. Problem to Get Care, Tests, or Treatment = Respondent reported having a problem in getting the care, tests, or treatment that a parent or doctor believed the child needed. Delayed Urgent Care, Problem in Getting Care, or Problem in Seeing Specialist = Respondent reported that child did not always get care as soon as was wanted for an illness, injury, or condition that needed care right away; that there was a problem in getting the care, tests, or treatment that a parent or doctor believed the child needed; or that there was a problem in seeing a specialist that the child needed to see. Any Unmet Needs = Respondent reported that child had any one or more of the following unmet healthcare needs within the past year: not always getting care as soon as was wanted for an illness, injury, or condition; having a problem in getting the care, tests, or treatment that a parent or doctor believed the child needed; having a problem in getting to see a specialist that the child needed to see; unable to get needed medical, dental, or prescription care; delay in getting needed medical, dental, or prescription care; whether it was a problem to not get needed medical, dental or prescription care.