Date: 31 Mar 2012
Factors Associated with Parent Report of Access to Care and the Quality of Care Received by Children 4 to 17 Years of Age in Georgia
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
We examined factors associated with health care access and quality, among children in Georgia. Data from the 2007 National Survey of Children’s Health were merged with the 2008 Area Resource File. The medically underserved area variable was appended to the merged file, restricting to Georgia children ages 4–17 years (N = 1,397). Study outcomes were past-year access to care, defined as utilization of preventive medical care and no occasion of delay or denial of needed care; and quality of care received, defined as compassionate, culturally-effective, and family-centered care which was categorized as higher, moderate, or lower. Analysis included binary and multinomial logit modeling. In our study population, 80.8 % were reported to have access to care. The quality of care distribution was: higher (39.4 %), moderate (30.6 %), and lower (30.0 %). Younger age (4–9 years) was positively associated with having access to care. Compared to children who had continuous and adequate private insurance, children who were never/intermittently insured or who had continuous and inadequate private insurance were less likely to have access. Compared to children who had continuous and adequate private insurance, there were lower odds of perceiving received care as higher/moderate versus lower quality among children who were never/intermittently insured or who had continuous and inadequate/adequate public insurance. Being in excellent/very good health and living in safe/supportive neighborhoods were positively associated with quality; non-white race/ethnicity and federal poverty level were negatively associated with quality. Assuring continuous, adequate insurance may positively impact health care access and quality.
Disclaimer: The findings and conclusions in this paper are those of the authors and do not necessarily represent the official position of the Research Data Center, the National Center for Health Statistics, or the Centers for Disease Control and Prevention.
Institute of Medicine. (1993). Access to health care in America (1st ed.). Washington, DC: National Academy Press.
Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.
Federico, S. G., Steiner, J. F., Beaty, B., Crane, L., & Kempe, A. (2007). Disruptions in insurance coverage: Patterns and relationship to health care access, unmet need, and utilization before enrollment in the State Children’s Health Insurance Program. Pediatrics, 120(4), e1009–e1016.PubMedCrossRef
Stein, J. A., Andersen, R., & Gelberg, L. (2007). Applying the Gelberg-Andersen behavioral model for vulnerable populations to health services utilization in homeless women. Journal of Health and Psychology, 12(5), 791–804.CrossRef
Raphael, J. L., Guadagnolo, B. A., Beal, A. C., & Giardino, A. P. (2009). Racial and ethnic disparities in indicators of a primary care medical home for children. Academic Pediatric, 9(4), 221–227.CrossRef
Shi, L., & Stevens, G. D. (2005). Disparities in access to care and satisfaction among U.S. children: The roles of race/ethnicity and poverty status. Public Health Reports, 120(4), 431–441.PubMed
Stevens, G. D., Pickering, T. A., Seid, M., & Tsai, K. Y. (2009). Disparities in the national prevalence of a quality medical home for children with asthma. Academic Pediatric, 9(4), 234–241.CrossRef
Martin, A. B., Probst, J., Wany, J. Y., & Hale, N. (2009). Effect of having a personal provider on access to dental care among children. Journal of Public Health Management and Practice, 15(3), 191–199.PubMed
Georgia Department of Community Health. (2010). Georgia five year needs assessments for the maternal and child health services Title V block grant.
U.S. Department of Health and Human Services. (2009). The national survey of children’s health 2007. Rockville, Maryland: U.S. Department of Health and Human Services.
Health Resources and Services Administration, Maternal and Child Health Bureau. (2011). Needs assessments. Available online: https://perfdata.hrsa.gov/MCHB/TVISReports/NeedsAssessment.aspx. Accessed March 3, 2011.
Institute of Medicine. (2011). Child and adolescent health and health care quality: Measuring what matters. Washington, DC: The National Academies Press.
Social Security Act. (2011). Compilation of social security laws: Child health quality measures. Available online: http://www.ssa.gov/OP_Home/ssact/title11/1139A.htm#ft147. Accessed July 5, 2011.
U.S. Department of Health and Human Services, Health Resources and Services Administration. (n.d.). Find shortage areas: MUA/P by state and county. Available online: http://muafind.hrsa.gov/. Accessed January 26, 2011.
American Academy of Pediatrics. (2007). Recommendations for preventive pediatric health care. Pediatrics, 120, 1376.
U.S. Department of Health and Human Services, Health Resources and Services Administration. (2011). National center for health workforce analysis: Area resource file. Available online: http://bhpr.hrsa.gov/healthworkforce/data/arf.htm. Accessed February 10, 2010.
U.S. Department of Health and Human Services, Health Resources and Services Administration. (1995). Medically underserved areas & populations (MUA/Ps). Available online: http://bhpr.hrsa.gov/shortage/muaps/index.html. Accessed June 29, 2011.
Aday, L. A., & Andersen, R. (1974). A framework for the study of access to medical care. Health Services Research, 9(3), 208–220.PubMed
Kaiser Commission on Medicaid and the Uninsured. (2003). How race/ethnicity, immigration status and language affect health insurance coverage, access to care and quality of care among the low-income population. Washington, DC: Kaiser Family Foundation.
Blumberg, S. J., Foster, E. B., Frasier, A. M. (forthcoming). Design and operation of the national survey of children’s health, 2007: National center for health statistics. Vital health stat 1.
Georgia Department of Community Health. (2010). Peach care for kids—Who is eligible? Available online: http://www.peachcare.org/FaqView.aspx?displayFaqId=104. Accessed May 12, 2011.
Children’s Health Insurance Program Reauthorization Act (CHIPRA). (2011). Outreach and enrollment grants—Cycle II. Centers for Medicare and Medicaid Services.
National Committee on Quality Assurance. (2011). Patient-centered medical home. Available online: http://www.ncqa.org/tabid/631/default.aspx. Accessed May 13, 2011.
- Factors Associated with Parent Report of Access to Care and the Quality of Care Received by Children 4 to 17 Years of Age in Georgia
Maternal and Child Health Journal
Volume 16, Issue 1 Supplement, pp 129-142
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Health care access
- Health care quality
- Health care utilization
- National Survey of Children’s Health
- Industry Sectors
- Author Affiliations
- 1. Division of Public Health, Georgia Department of Community Health, Atlanta, GA, USA
- 3. 2 Peachtree Street, NW, Suite 14-272, Atlanta, GA, 30303, USA
- 2. Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA