Wood D L, Hayward R A, Corey C R, Freeman H E, Shapiro M F
RAND Corporation, Santa Monica, California.
Pediatrics. 1990 Nov;86(5):666-73.
To evaluate access to health care for American children and adolescents, a telephone survey of a national random sample of households was conducted in which 2182 children 17 years or younger were studied. Approximately 10% had no medical insurance; 10% had no regular source of care; and 18% identified emergency rooms, community clinics, or hospital outpatient departments as their usual site of medical care. Children who were uninsured, poor, or nonwhite were less likely to have seen a physician in the past year (P less than .001), and uninsured children were less likely to have up-to-date immunizations. Logistic regression analyses revealed that poor, uninsured, or nonwhite children less frequently had a regular source of care; more frequently used emergency rooms, community clinics, and hospital outpatient departments as their regular providers; and more frequently encountered financial barriers to health care. Low-income or nonwhite children had much less access to care compared with children from more affluent or white families, independent of insurance status or health status.
为评估美国儿童和青少年获得医疗保健服务的情况，对全国随机抽取的家庭样本进行了电话调查，共研究了2182名17岁及以下儿童。约10%的儿童没有医疗保险；10%没有固定的医疗保健来源；18%将急诊室、社区诊所或医院门诊部作为他们通常的医疗场所。未参保、贫困或非白人儿童在过去一年看医生的可能性较小（P<0.001），未参保儿童进行最新免疫接种的可能性也较小。逻辑回归分析显示，贫困、未参保或非白人儿童较少有固定的医疗保健来源；更频繁地将急诊室、社区诊所和医院门诊部作为其常规医疗服务提供者；并且更频繁地遇到医疗保健的经济障碍。与来自富裕或白人家庭的儿童相比，低收入或非白人儿童获得医疗服务的机会要少得多，这与保险状况或健康状况无关。
