Children Who Lack Continuity With a Regular Health Care Provider Miss Needed Services

http://www.sciencedaily.com/releases/2009/11/091123171414.htm

ScienceDaily (Nov. 23, 2009) — Low-income children who don't access health care from the same place or provider over the long term are significantly more likely to have unmet health care needs compared with those do, according to a new study published in the journal Pediatrics.

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Previous studies have shown that patients who maintain an ongoing relationship with a primary care facility or provider, also known as a "usual source of care," are more likely to use preventive health care, not use emergency services and have shorter hospital stays. In this study, DeVoe and colleagues expanded on that research by examining whether having a consistent place or person from whom to access regular health care over time affects low-income children's ability to access needed services.

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Based on these responses, the researchers report that 79 percent of the children who lacked a usual source of health care had an unmet need compared with 45 percent who reported having a usual source of care.

The researchers then compared their findings with a comparable national sample and found 67.5 percent of low-income children nationwide who lacked a usual source of care had an unmet need compared with 37 percent who reported having a usual source of care.

"A child without a usual source of care had at least two times the odds of experiencing an unmet need than a child with a usual source of care both in the Oregon population and in the national sample," DeVoe explained.

In addition, the researchers were interested in knowing whether children whose insurance changes had prompted a change in their usual source of care were more vulnerable to experiencing unmet need. They found that an estimated 23 percent of low-income children in Oregon had changed their usual source of care because of insurance reasons. Compared to children with a stable usual source of care, the group that had changed their usual source of care had 2.6 times the odds of experiencing unmet medical care needs.

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