Uninsured Children Three Times as Likely to Miss Necessary Care

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UNINSURED CHILDREN THREE TIMES AS LIKELY TO MISS NECESSARY CARE Study finds families also report less satisfaction with care

MADISON -- Children without health insurance are more than three times as likely to go without necessary health care as insured children are, according to a new study of nearly 50,000 children nationwide.

Uninsured children are also six times as likely as insured children not to have a usual source of primary medical care.

The findings are published in the Feb. 19 edition of the New England Journal of Medicine. Dr. Jeffrey Stoddard, assistant professor of pediatrics at the University of Wisconsin Medical School, is one of the paperπs authors.

The goal of the study was to assess the role of insurance in relation to childrenπs access to primary care, defined by the American Academy of Pediatrics as ≥accessible and affordable, first contact, continuous and comprehensive, and coordinated to meet the health needs of the individual and family being served.≤ The research team analyzed a sample of 50,000 children under 18 from the 1993-94 National Health Interview Survey, a nationwide household survey that included questions on insurance coverage and access to primary care.

About 13 percent of American children lacked health insurance in 1993-94. The research team gauged several significant disparities between insured and uninsured children: -more- Uninsured children/add one

Ä Nearly a quarter (24 percent) of uninsured children lacked a usual source of medical care; just 4 percent of insured children did.

Ä Uninsured children were almost twice as likely as insured children to have no regular doctor at their usual site of care.

Ä While approximately eight percent of all children did not receive necessary health care during the preceding year, 22 percent of uninsured children were reportedly unable to obtain a necessary service.

Ä Families of uninsured children were about 40 percent more likely to report dissatisfaction with either the quality of care, waiting time for an appointment, or the way their questions were answered.

Ä Nearly three of four families with uninsured children cited expense as the main reason for lacking coverage.

≥The fact that many American children are uninsured is already well known,≤ said Stoddard, a practicing pediatrician at UW Childrenπs Hospital in Madison. ≥But the implications of the lack of coverage are disturbing. When children lack a regular doctor who knows their history, the continuity of their care suffers. When care is delayed or absent altogether, the likelihood of more serious and costly illness goes up.≤

Stoddard said the findings underscore the importance of recent federal legislation that enables states to provide health insurance to uninsured children in poor families. Wisconsinπs Badger Care program will provide health insurance to thousands of low-income children beginning this spring. He also pointed out the findings suggest that disparities between insured and uninsured children might have worsened somewhat since 1987, the last time similar data were collected nationally.

Primary author Paul Newacheck and other members of the research team are at the University of California-San Francisco. The research study was supported by a grant from the Robert Wood Johnson Foundation, a national health care philanthropy.

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