Parent and Child Usual Source of Care and Children’s Receipt of Health Care Services

FPL = federal poverty level; MEPS-HC = Medical Expenditure Panel Survey-Household Component.

Source: 2002–2007 MEPS-HC.

Note: Column percentages are weighted and may not equal 100% because of rounding (rounded to nearest 10th). P <.05 in χ3 test comparisons of overall differences between subgroups of each covariate and insurance patterns.

↵a Unweighted counts represent total number of children, aged 0–17 years, from MEPS-HC respondent households with a positive person weight who could be linked to at least 1 parent within the household. Total counts do not include 2,049 children with no parent identified in the household; cross-sectional total also excludes 437 children for whom self or parental USC status could not be ascertained.

↵b To derive yearly population estimates, each child record from MEPS-HC was weighted according to person-level weights provided by the data collection agency.

↵c Household income groups were based on MEPS-HC–constructed variable that divides families into 5 income groups based on earnings as a percentage of federal poverty level (FPL), and in 2007, the federal poverty level for a family of 4 was $20,650.³⁷

↵d Child’s race/ethnicity based on responses to standard options provided by MEPS-HC interviewers. We created 1 child race/ethnicity variable by combining a race variable (which included white only, black only, American Indian/Alaskan Native only, Asian only, native Hawaiian/Pacific Islander only, and multiple races) and an ethnicity variable (which included Hispanic, or not Hispanic).

↵e Family composition refers to whether the child could be linked to 1 parent (n = 17,612) or 2 parents (n = 38,690) residing in the same household (does not account for biological relationship between parent and child or the marriage status between the 2 parents).

Source: 2002–2007 Medical Expenditure Panel Survey-Household Component (MEPS-HC).

Note: P <.05 in χ3 test comparisons of overall differences between insurance pattern subgroups and all outcome measures.

↵a To derive the yearly population estimates, each child record from the MEPS-HC was weighted according to person-level weights provided by the data collection agency.

↵b Unweighted counts represent total number of children, aged 0–17 years, from MEPS-HC–respondent households with a positive person weight who could be linked to at least 1 parent within the household. Total counts do not include 2,049 children with no parent identified in the household. Total also excludes 437 children for whom USC status could not be ascertained for the child and/or parent.

↵c Unmet medical or prescription need was defined as being unable to get medical care and/or prescription medications when needed within the past year.

↵d Delayed care was defined as parental report that child did not always get care as soon as was wanted for an illness, injury, or condition that needed care right away; or did not always get an appointment for routine health care as soon as was wanted.

↵e Problems getting care was defined as parent reporting a big or small problem that child did not receive needed medical or prescription treatment; a big or small problem to get the child care, tests, or treatment a parent or doctor believed necessary; or a big or small problem to see a specialist the child needed to see.

↵f The preventive counseling services include MEPS-HC items that asked parents whether a doctor or health care clinician had advised their child about the importance of (1) healthy eating, (2) routine exercise, (3) use of car safety seats/booster seats/seat belts, and (4) use of a helmet while riding a tricycle/bicycle.

↵g In the past 2 years among all children, 39.8% were missing all 4 preventive counseling items; 16.7% were missing 3 items; 15.3% were missing 2 items; 11.4% were missing 1 item (16.8% had received all 4 items).

↵h Over a lifetime among all children, 33.4% were missing all 4 preventive counseling items; 16.9% were missing 3 items; 16.5% were missing 2 items; 13.2% were missing 1 item (20.1% had received all 4 items).

Source: 2002–2007 Medical Expenditure Panel Survey-Household Component.

aRR = adjusted risk ratio; FPL = federal poverty level; USC = usual source of care.

↵a Yearly doctor visits were chosen as an unmet need variable because the American Academy of Pediatrics recommends yearly preventive pediatric health care visits up to age 21 years.³²

↵b American Academy of Pediatric Dentistry recommends yearly dental visits begin at time of first tooth and no later than 12 months of age.³³

↵c Unmet medical or prescription need was defined as being unable to get medical care and/or prescription medications when needed within the past year.

↵d Delayed care was defined as parental report that child did not always get care as soon as was wanted for an illness, injury, or condition that needed care right away; or did not always get an appointment for routine health care as soon as was wanted.

↵e Problems getting care was defined as parent reporting a big or small problem that the child did not receive needed medical or prescription treatment; a big or small problem to get the child care, tests, or treatment a parent or doctor believed necessary; or a big or small problem to see a specialist the child needed to see.

↵f Reference group.

↵g P <.05.