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Timely Access to Quality Health Care Among Georgia Children Ages 4 to 17 Years

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Abstract

We examined factors associated with children’s access to quality health care, a major concern in Georgia, identified through the 2010 Title V Needs Assessment. Data from the 2007 National Survey of Children’s Health were merged with the 2008 Area Resource File and Health Resources and Services Administration medically underserved area variable, and restricted to Georgia children ages 4–17 years (N = 1,397). The study outcome, access to quality health care was derived from access to care (timely utilization of preventive medical care in the previous 12 months) and quality of care (compassionate/culturally effective/family-centered care). Andersen’s behavioral model of health services utilization guided independent variable selection. Analyses included Chi-square tests and multinomial logit regressions. In our study population, 32.8 % reported access to higher quality care, 24.8 % reported access to moderate quality care, 22.8 % reported access to lower quality care, and 19.6 % reported having no access. Factors positively associated with having access to higher/moderate versus lower quality care include having a usual source of care (USC) (adjusted odds ratio, AOR:3.27; 95 % confidence interval, 95 % CI 1.15–9.26), and special health care needs (AOR:2.68; 95 % CI 1.42–5.05). Lower odds of access to higher/moderate versus lower quality care were observed for non-Hispanic Black (AOR:0.31; 95 % CI 0.18–0.53) and Hispanic (AOR:0.20; 95 % CI 0.08–0.50) children compared with non-Hispanic White children and for children with all other forms of insurance coverage compared with children with continuous-adequate-private insurance. Ensuring that children have continuous, adequate insurance coverage and a USC may positively affect their access to quality health care in Georgia.

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References

  1. Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC.

  2. Starfield, B., Shi, L., & Macinko, J. (2005). Contribution of primary care to health systems and health. Milbank Quarterly, 83(3), 457–502.

    Article  PubMed  Google Scholar 

  3. Institute of Medicine. (1993). Access to health care in America. Washington, DC.

  4. Georgia Department of Community Health. (2010). Georgia five year needs assessments for the maternal and child health services Title V block grant.

  5. Halterman, J. S., Montes, G., Shone, L. P., & Szilagyi, P. G. (2008). The impact of health insurance gaps on access to care among children with asthma in the United States. Ambulatory Pediatrics, 8(1), 43–49.

    Article  PubMed  Google Scholar 

  6. Institute of Medicine. (1998). America’s children: Health insurance and access to care. Washington, DC: National Academy of Sciences.

    Google Scholar 

  7. U.S. Department of Health and Human Services. (2009). The National Survey of Children’s Health 2007. Rockville, Maryland.

  8. Data Resource Center for Child and Adolescent Health. (2009). Georgia: Medical home performance profile for all children. http://medicalhomedata.org/Content/NSCHProfile.aspx. Accessed November 20th, 2009.

  9. Cassedy, A., Fairbrother, G., & Newacheck, P. W. (2008). The impact of insurance instability on children’s access, utilization, and satisfaction with health care. Ambulatory Pediatrics, 8(5), 321–328.

    Article  PubMed  Google Scholar 

  10. Cummings, J. R., Lavarreda, S. A., Rice, T., & Brown, E. R. (2009). The effects of varying periods of uninsurance on children’s access to health care. Pediatrics, 123(3), e411–e418.

    Article  PubMed  Google Scholar 

  11. 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.

    Article  PubMed  Google Scholar 

  12. Flores, G., & Tomany-Korman, S. C. (2008). Racial and ethnic disparities in medical and dental health, access to care, and use of services in US children. Pediatrics, 121(2), e286–e298.

    Article  PubMed  Google Scholar 

  13. Granados, G., Puvvula, J., Berman, N., & Dowling, P. T. (2001). Health care for Latino children: Impact of child and parental birthplace on insurance status and access to health services. American Journal of Public Health, 91(11), 1806–1807.

    Article  PubMed  CAS  Google Scholar 

  14. Kogan, M. D., Newacheck, P. W., Blumberg, S. J., Ghandour, R. M., Singh, G. K., Strickland, B. B., et al. (2010). Underinsurance among children in the United States. New England Journal of Medicine, 363(9), 841–851.

    Google Scholar 

  15. Lo, K. M., & Fulda, K. G. (2008). Impact of predisposing, enabling, and need factors in accessing preventive medical care among U.S. children: Results of the national survey of children’s health. Osteopathic Medicine and Primary Care, 2, 12.

    Article  PubMed  Google Scholar 

  16. 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.

    Article  Google Scholar 

  17. 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  Google Scholar 

  18. Stevens, G. D. (2006). Gradients in the health status and developmental risks of young children: the combined influences of multiple social risk factors. Maternal and Child Health Journal, 10(2), 187–199.

    Article  PubMed  Google Scholar 

  19. Yu, S. M., Bellamy, H. A., Kogan, M. D., Dunbar, J. L., Schwalberg, R. H., & Schuster, M. A. (2002). Factors that influence receipt of recommended preventive pediatric health and dental care. Pediatrics, 110(6), e73.

    Article  PubMed  Google Scholar 

  20. 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.

    Article  Google Scholar 

  21. Stevens, G. D., Seid, M., Pickering, T. A., & Tsai, K. Y. (2010). National disparities in the quality of a medical home for children. Maternal and Child Health Journal, 14(4), 580–589.

    Google Scholar 

  22. Centers for Disease Control and Prevention. (2010). NCHS Research Data Center (RDC). http://www.cdc.gov/rdc/. Published 2009. Accessed May 5, 2010.

  23. Blumberg, S. J., Foster, E. B., & Frasier, A. M. (2007). Design and Operation of the National Survey of Children’s Health, 2007: National Center for Health Statistics.

  24. U.S. Department of Health and Human Services: Health Resources and Services Administration. (2010). National Center for Health Workforce Analysis: Area Resource File. http://bhpr.hrsa.gov/healthworkforce/data/arf.htm. Published 2011. Accessed February 10, 2010.

  25. U.S. Department of Health and Human Services: Health Resources and Services Administration. (2011). Find shortage areas: MUA/P by State and County. http://muafind.hrsa.gov/. Accessed January 26, 2011.

  26. American Academy of Pediatrics. (2007). Recommendations for preventive pediatric health care. Pediatrics, 120, 1376.

  27. Ogbuanu, C., Goodman, D., Kahn, K., Noggle, B., Long, C., Bagchi, S., Barradas, D., & Castrucci, B. (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. Maternal and Child Health Journal, 16(S1), 129–142.

    Google Scholar 

  28. Larson, K., & Halfon, N. (2010). Family income gradients in the health and health care access of US children. Maternal and Child Health Journal, 14(3), 332–342.

    Google Scholar 

  29. 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  Google Scholar 

  30. Aday, L. A., & Andersen, R. (1974). A framework for the study of access to medical care. Health Services Research, 9(3), 208–220.

    PubMed  CAS  Google Scholar 

  31. Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36(1), 1–10.

    Article  PubMed  CAS  Google Scholar 

  32. 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 Psychology, 12(5), 791–804.

    Article  PubMed  Google Scholar 

  33. Yu, S. M., Huang, Z. J., & Kogan, M. D. (2008). State-level health care access and use among children in US immigrant families. American Journal of Public Health, 98(11), 1996–2003.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors gratefully acknowledge the staff of the Atlanta Research Data Center, Stephanie Robinson and Alex Erhlich, for their support throughout the study period. We are also grateful to Deborah Rosenberg, Associate Professor, and Kristin Rankin, Research Assistant Professor, both at the University of Illinois, Chicago, for their support, guidance and encouragement as instructors of the survey course out of which this publication was developed.

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Authors and Affiliations

  1. Maternal and Child Health Epidemiology Section, Maternal and Child Health Program, Division of Public Health, Georgia Department of Community Health, 2 Peachtree Street, NW, Atlanta, GA, 30303, USA

    Chinelo Ogbuanu, Katherine Kahn, Cherie Long, Brendan Noggle & Brian Castrucci

  2. Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA

    David A. Goodman & Danielle Barradas

  3. Behavioral Surveillance Team Lead, Chronic Disease, Healthy Behaviors and Injury Epidemiology Section, Epidemiology Program, Division of Public Health, Georgia Department of Community Health, 2 Peachtree Street, NW, 14th floor, Atlanta, GA, 30303, USA

    Suparna Bagchi

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  1. Chinelo Ogbuanu
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  2. David A. Goodman
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  3. Katherine Kahn
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  4. Cherie Long
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  5. Brendan Noggle
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  6. Suparna Bagchi
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  7. Danielle Barradas
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  8. Brian Castrucci
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Correspondence to Chinelo Ogbuanu.

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CDC Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Ogbuanu, C., Goodman, D.A., Kahn, K. et al. Timely Access to Quality Health Care Among Georgia Children Ages 4 to 17 Years. Matern Child Health J 16 (Suppl 2), 307–319 (2012). https://doi.org/10.1007/s10995-012-1146-0

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  • DOI: https://doi.org/10.1007/s10995-012-1146-0

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