Having a usual source of care promotes preventive health counseling for children
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.
— KB
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