Access to medical care for children and adolescents in the United States

• Published in: Pediatrics (Evanston) Vol. 86; no. 5; pp. 666 - 673
• Main Authors: Wood, D L, Hayward, R A, Corey, C R, Freeman, H E, Shapiro, M F
• Format: Journal Article
• Language: English
• Published: United States American Academy of Pediatrics 01-11-1990
• Subjects: Adolescent; Child; Child health services; Child, Preschool; Continental Population Groups; Evaluation; Health aspects; Health Services - utilization; Health Services Accessibility - economics; Health Services Accessibility - standards; Health Services Misuse - statistics & numerical data; Health Services Research; Humans; Income; Infant; Insurance, Health - statistics & numerical data; Medicaid; Minorities; Poor children; Poverty; Random Allocation; Selection Bias; Telephone; United States; United States
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.86.5.666

To evaluate access to health care for American children and adolescents, a telephone survey of a national random sample of households was conducted in which 2182 children 17 years or younger were studied. Approximately 10% had no medical insurance; 10% had no regular source of care; and 18% identified emergency rooms, community clinics, or hospital outpatient departments as their usual site of medical care. Children who were uninsured, poor, or nonwhite were less likely to have seen a physician in the past year (P less than .001), and uninsured children were less likely to have up-to-date immunizations. Logistic regression analyses revealed that poor, uninsured, or nonwhite children less frequently had a regular source of care; more frequently used emergency rooms, community clinics, and hospital outpatient departments as their regular providers; and more frequently encountered financial barriers to health care. Low-income or nonwhite children had much less access to care compared with children from more affluent or white families, independent of insurance status or health status.