Kandyce Larson1, William L Cull1, Andrew D Racine2, Lynn M Olson3. 1. Division of Health Services Research and. 2. Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York. 3. Department of Research, American Academy of Pediatrics, Elk Grove Village, Illinois; and lolson@aap.org.
Abstract
BACKGROUND AND OBJECTIVE: Recent years have witnessed substantial gains in health insurance coverage for children, but few studies have examined trends across a diverse set of access indicators. We examine US children's access to health services and whether trends vary by race/ethnicity and income. METHODS: Analysis of 178 038 children ages 0 to 17 from the 2000 to 2014 National Health Interview Survey. Trends are examined for health insurance and 5 access indicators: no well-child visit in the year, no doctor office visit, no dental visit, no usual source of care, and unmet health needs. Logistic regression models add controls for sociodemographics and child health status. Statistical interactions test whether trends vary by race/ethnicity and income. RESULTS: Among all children, uninsured rates declined from 12.1% in 2000 to 5.3% in 2014, with improvement across all 5 access indicators. Along with steep declines in the uninsured rate, Hispanic children had sizeable improvement for no doctor office (19.8% to 11.9%), no dental visit (43.2% to 21.8%), and no usual source of care (13.9% to 6.3%). Black children and those in poor and near-poor families also had large gains. Results from adjusted statistical interaction models showed more improvement for black and Hispanic children versus whites for 3 of 5 access indicators and for children in poor and near-poor families for 4 of 5 access indicators. CONCLUSIONS: Children's access to health services has improved since 2000 with greater gains in vulnerable population groups. Findings support a need for continued support of health insurance for all children.
BACKGROUND AND OBJECTIVE: Recent years have witnessed substantial gains in health insurance coverage for children, but few studies have examined trends across a diverse set of access indicators. We examine US children's access to health services and whether trends vary by race/ethnicity and income. METHODS: Analysis of 178 038 children ages 0 to 17 from the 2000 to 2014 National Health Interview Survey. Trends are examined for health insurance and 5 access indicators: no well-child visit in the year, no doctor office visit, no dental visit, no usual source of care, and unmet health needs. Logistic regression models add controls for sociodemographics and child health status. Statistical interactions test whether trends vary by race/ethnicity and income. RESULTS: Among all children, uninsured rates declined from 12.1% in 2000 to 5.3% in 2014, with improvement across all 5 access indicators. Along with steep declines in the uninsured rate, Hispanic children had sizeable improvement for no doctor office (19.8% to 11.9%), no dental visit (43.2% to 21.8%), and no usual source of care (13.9% to 6.3%). Black children and those in poor and near-poor families also had large gains. Results from adjusted statistical interaction models showed more improvement for black and Hispanic children versus whites for 3 of 5 access indicators and for children in poor and near-poor families for 4 of 5 access indicators. CONCLUSIONS:Children's access to health services has improved since 2000 with greater gains in vulnerable population groups. Findings support a need for continued support of health insurance for all children.
Authors: Esther K Adams; Andrea E Strahan; Peter J Joski; Jonathan N Hawley; Veda C Johnson; Carol J Hogue Journal: Am J Prev Med Date: 2020-08-27 Impact factor: 5.043
Authors: Ariel A Williamson; Sonia L Rubens; Kristina E Patrick; Melisa Moore; Jodi A Mindell Journal: J Clin Sleep Med Date: 2017-11-15 Impact factor: 4.062
Authors: Martha Y Kubik; Jayne A Fulkerson; John R Sirard; Ann Garwick; Judy Temple; Olga Gurvich; Jiwoo Lee; Bonnie Dudovitz Journal: Contemp Clin Trials Date: 2018-10-18 Impact factor: 2.226
Authors: Ashley M Kranz; Rachel Ross; Mark Sorbero; Aaron Kofner; Bradley D Stein; Andrew W Dick Journal: J Am Dent Assoc Date: 2020-02-17 Impact factor: 3.634