Parent and Child Usual Source of Care and Children's Receipt of Health Care Services
Parent and Child Usual Source of Care and Children's Receipt of Health Care Services
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DOI：
10.1370/afm.1300
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发表时间：
2011-11-01
影响因子：
4.4
通讯作者：
Gold, Rachel
中科院分区：
文献类型：
--
作者：
DeVoe, Jennifer E.;Tillotson, Carrie J.;Gold, Rachel
在美国，拥有常规护理来源（USC）的儿童比没有常规护理来源的儿童更容易获得医疗保健服务，但对父母USC如何影响儿童获得医疗保健服务知之甚少。我们研究了儿童和父母USC模式与儿童获得医疗保健服务之间的关系。方法：我们对参与2002-2007年医疗支出小组调查（n = 56,302）的儿童进行了具有全国代表性的横断面数据的二次分析。我们评估了10项结果指标：保险覆盖缺口、过去一年没有看医生、少于每年看牙医、未满足的医疗和处方需求、延迟护理、获得护理的问题、未满足的关于健康饮食、定期锻炼、汽车安全装置和自行车头盔的预防性咨询需求。在儿童中，78.6%的儿童有USC，且至少有一位父母有USC，而12.4%的儿童有USC，但没有父母USC。与父母有USC的儿童相比，有USC但没有父母有USC的儿童有几种未满足需求的可能性更高，包括保险覆盖缺口（调整风险比[aRR] 1.33； 95%置信区间[Cl]， 1.21-1.47），未满足的医疗或处方需求（aRR 1.70; 95% CI 1.09-2.65），没有每年牙科就诊（aRR 1.12; 95% CI 1.06-1.18）。结论：在有USC的儿童中，与父母有USC的儿童相比，父母没有USC的儿童报告未满足需求的可能性更高。政策改革应确保所有家庭成员都能进入南加州大学。
PURPOSE In the United States, children who have a usual source of care (USC) have better access to health care than those who do not, but little is known about how parental USC affects children's access. We examined the association between child and parent USC patterns and children's access to health care services.METHODS We undertook a secondary analysis of nationally representative, cross-sectional data from children participating in the 2002-2007 Medical Expenditure Panel Survey (n = 56,302). We assessed 10 outcome measures: insurance coverage gaps, no doctor visits in the past year, less than yearly dental visits, unmet medical and prescription needs, delayed care, problems getting care, and unmet preventive counseling needs regarding healthy eating, regular exercise, car safety devices, and bicycle helmets.RESULTS Among children, 78.6% had a USC and at least 1 parent with a USC, whereas 12.4% had a USC but no parent USC. Children with a USC but no parent USC had a higher likelihood of several unmet needs, including an insurance coverage gap (adjusted risk ratio [aRR] 1.33; 95% confidence interval [Cl], 1.21-1.47), an unmet medical or prescription need (aRR 1.70; 95% CI 1.09-2.65), and no yearly dental visits (aRR 1.12; 95% CI 1.06-1.18), compared with children with a USC whose parent(s) had a USC.CONCLUSIONS Among children with a USC, having no parent USC was associated with a higher likelihood of reporting unmet needs when compared with children whose parent(s) had a USC. Policy reforms should ensure access to a USC for all family members.