The Effects of Health Insurance and a Usual Source of Care on a Child’s Receipt of Health Care

• Published in: Journal of pediatric health care Vol. 26; no. 5; pp. e25 - e35
• Main Authors: DeVoe, Jennifer E., MD, DPhil, Tillotson, Carrie J., MPH, Wallace, Lorraine S., PhD, Lesko, Sarah E., MD, MPH, Angier, Heather, MPH
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01-09-2012
• Subjects: access to health care; Adolescent; Advanced Practice Nursing; Child; Child health; Child Health Services - economics; Child Health Services - utilization; Child, Preschool; Cross-Sectional Studies; Female; health care disparities; Health Care Reform; health insurance; health policy; Health Services Accessibility - economics; Health Services Accessibility - statistics & numerical data; Humans; Infant; Infant, Newborn; Insurance Coverage - economics; Insurance Coverage - statistics & numerical data; Insurance, Health - economics; Insurance, Health - statistics & numerical data; Male; Nursing; Parents; Pediatrics; Primary Health Care - economics; Primary Health Care - utilization; Socioeconomic Factors; United States - epidemiology; usual source of care; United States; access to health care; health policy; health care reform; health insurance; Child health; usual source of care; health care disparities
• ISSN: 0891-5245; 1532-656X
• DOI: 10.1016/j.pedhc.2011.01.003

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.