Having a usual source of care promotes preventive health counseling for children
Research Activities, July 2012, No. 383
Preventive health counseling (PHC) is an important health care service for children. Recommended PHC topics include eating healthy foods and getting exercise; using seat belts, safety car seats, and bicycle helmets; and preventing exposure to second-hand smoke. Having a usual source of care (USC) is equally or more important than health insurance when it comes to receiving PHC, concludes a new study. Yet, nearly 10 percent of children do not have a USC and the percentage is higher among the uninsured.
The researchers analyzed data from 2002 through 2006 from the Medical Expenditure Panel Survey—Household Component (MEPS-HC) of the Agency for Healthcare Research and Quality (AHRQ). As part of 5 interviews during a 2-year period, parents were asked if they had ever received guidance from a health care provider on the health and safety topics listed above for their child. The survey also provided a rich source of sociodemographic characteristics, USC types, and insurance coverage details.
More than three-quarters of children (76.8 percent) had both a USC and continuous health insurance coverage in a given year. Another 14 percent had a USC but were uninsured. Five percent of children had insurance but no USC; 4.2 percent had neither continuous insurance nor a USC. The children with both health insurance and a USC had the lowest rates of missed PHC. Children without insurance and without a USC had the highest missed rates. However, children with insurance and no USC were more likely to have never received PHC on the five topics than uninsured children with a USC. According to the researchers, expanding health insurance is not enough to ensure optimal PHC for children. More efforts are needed to expand primary care resources, increase delivery of this needed counseling, and find a USC for every child. The study was supported in part by AHRQ (HS16181 and HS18596).
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 Maternal and Child Health Journal 16, pp. 306-315, 2012.