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
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.
KeywordsChildren Health care access Health care quality Health care utilization National Survey of Children’s Health
- 1.Institute of Medicine. (1993). Access to health care in America (1st ed.). Washington, DC: National Academy Press.Google Scholar
- 2.Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.Google Scholar
- 5.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.PubMedCrossRefGoogle Scholar
- 20.Georgia Department of Community Health. (2010). Georgia five year needs assessments for the maternal and child health services Title V block grant.Google Scholar
- 21.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.Google Scholar
- 22.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.
- 23.Institute of Medicine. (2011). Child and adolescent health and health care quality: Measuring what matters. Washington, DC: The National Academies Press.Google Scholar
- 24.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.
- 25.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.
- 26.American Academy of Pediatrics. (2007). Recommendations for preventive pediatric health care. Pediatrics, 120, 1376.Google Scholar
- 27.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.
- 28.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.
- 34.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.Google Scholar
- 35.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.Google Scholar
- 38.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.
- 39.Children’s Health Insurance Program Reauthorization Act (CHIPRA). (2011). Outreach and enrollment grants—Cycle II. Centers for Medicare and Medicaid Services.Google Scholar
- 40.National Committee on Quality Assurance. (2011). Patient-centered medical home. Available online: http://www.ncqa.org/tabid/631/default.aspx. Accessed May 13, 2011.
- 41.Anderson, R. T., Weisman, C. S., Camacho, F., Scholle, S. H., Henderson, J. T., & Farmer, D. F. (2007). Women’s satisfaction with their on-going primary health care services: A consideration of visit-specific and period assessments. Health Services Research, 42(2), 663–681.PubMedCrossRefGoogle Scholar