Department of Family Medicine, Oregon Health & Science University, Portland, OR 97239, USA.
J Pediatr Health Care. 2012 Sep-Oct;26(5):e25-35. doi: 10.1016/j.pedhc.2011.01.003. Epub 2011 Mar 2.
Although recent health care reforms will expand insurance coverage for U.S. children, disparities regarding access to pediatric care persist, even among the insured. We investigated the separate and combined effects of having health insurance and a usual source of care (USC) on children's receipt of health care services.
We conducted secondary analysis of the nationally representative 2002-2007 Medical Expenditure Panel Survey data from children (≤ 18 years of age) who had at least one health care visit and needed any additional care, tests, or treatment in the preceding year (n = 20,817).
Approximately 88.1% of the study population had both a USC and insurance; 1.1% had neither one; 7.6% had a USC only, and 3.2% had insurance only. Children with both insurance and a USC had the fewest unmet needs. Among insured children, those with no USC had higher rates of unmet needs than did those with a USC.
Expansions in health insurance are essential; however, it is also important for every child to have a USC. New models of practice could help to concurrently achieve these goals.
尽管最近的医疗改革将扩大美国儿童的保险范围，但在获得儿科保健方面仍存在差距，即使在已参保的儿童中也是如此。我们研究了拥有健康保险和常规医疗服务提供者（USC）对儿童获得医疗服务的分别和综合影响。
我们对来自有至少一次医疗就诊且在过去一年需要额外护理、检查或治疗的儿童（≤18 岁）的具有全国代表性的 2002-2007 年医疗支出面板调查数据进行了二次分析（n=20817）。
研究人群中约有 88.1%同时拥有 USC 和保险；1.1%两者都没有；7.6%只有 USC，3.2%只有保险。同时拥有保险和 USC 的儿童未满足需求的比例最低。在有保险的儿童中，没有 USC 的儿童未满足需求的比例高于有 USC 的儿童。
扩大健康保险范围至关重要；然而，每个儿童都有 USC 也同样重要。新的实践模式可以帮助同时实现这两个目标。
