A usual source of care may be more important than insurance on children's receipt of preventive health counseling
Although insurance coverage is necessary to access care, it may not be sufficient. In fact, a new study suggests that a usual source of care may play an equally or more important role than health insurance in ensuring that a child receives preventive health counseling.It found that children with neither health insurance nor a usual source of care (USC) had the highest rates of missed counseling, while children with both insurance and a USC had the lowest rates of missed counseling. Children with only insurance were more likely than those with only a USC to have never received preventive health counseling from a health care provider regarding healthy eating, regular exercise, use of car safety devices, use of bicycle helmets, and risk of second-hand smoke exposure.
The researchers examined 2002-2006 data on children 17 years or younger from the nationally representative Medical Expenditure Panel Survey. Parents answered whether they had received anticipatory guidance from a health care provider regarding these five areas of preventive health counseling. Preventive health counseling was estimated to be received by less than half of all children.
The results suggest that expanding eligibility of the Children's Health Insurance Program or mandating health insurance coverage for everyone will not achieve optimal delivery of preventive health counseling without a mechanism to ensure adequate provider capacity. Although a higher percentage of insured children had a USC, it cannot be assumed that gaining stable health insurance will automatically lead to finding a USC, note the researchers. Their study was supported by the Agency for Healthcare Research and Quality (HS16181).
See "Is health insurance enough? A usual source of care may be more important to ensure a child receives preventive health counseling," by Jennifer E. DeVoe, M.D., Carrie J. Tillotson, M.P.H., Lorraine S. Wallace, Ph.D., and others in the March 4, 2011, Maternal Child Health Journal [Epub ahead of print].
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