Health insurance is necessary but not sufficient for children's access to care
Recent Federal health care reform legislation focuses on expanding health insurance. Insurance coverage is often necessary to access care, but it is not sufficient, especially if individuals do not have a regular source of care, suggests a new study.
Jennifer E. DeVoe, M.D., D.Phil., of the Oregon Health and Science University, and colleagues examined the separate and combined effects of having health insurance and/or a usual source of care (USC) on a child's parental-reported access to health care services and unmet health care needs. Using a broad national sample, they found that 95.8 percent of children age 18 and under had a USC and 91.3 percent had health insurance. An estimated 88.1 percent had both a USC and insurance while 1.1 percent had neither. A further 7.6 percent had a USC only, and 3.2 percent had insurance only. For children, having continuous health insurance and a USC was associated with the lowest percentage of unmet needs, while having neither one was associated with the highest percentage of unmet needs. The uninsured without a USC had the worst care access in all cases. They were more than 2.5 times as likely to have an unmet medical, dental, and/or prescription medication need compared with the group having a USC and insurance.
The researchers analyzed data from the Agency for Healthcare Research and Quality's Medical Expenditure Panel Survey on a nationally representative sample of 193,119 children from 2003 through 2007. They concluded that proposals to greatly expand eligibility for the Children's Health Insurance Program or to mandate individual health insurance coverage will not achieve optimal or equitable access to pediatric health care services without a mechanism to ensure adequate provider capacity. The study was supported by the Agency for Healthcare Research and Quality (HS16181).
See "The effects of health insurance and a usual source of care on a child's receipt of health care," by Dr. DeVoe, Carrie J. Tillotson, M.P.H., Lorraine S. Wallace, Ph.D., and others in the February 14, 2011, Journal of Pediatric Health Care (epub ahead of print).
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