Location of usual source of care among children and adolescents in the US, 1997–2013

Details

• Alternative Title:
  J Pediatr
• Personal Author:
  Simon, Alan E. ; Rossen, Lauren ; Schoendorf, Kenneth C. ; Larson, Kandyce ; Olson, Lynn M.
• Description:
  Objectives
  
  To examine national trends in the percentage of children whose usual source of care is at a clinic, health center, or hospital outpatient department (hereafter “clinics”) and whether trends differ by sociodemographic subpopulations. Clinics have a greater percentage of patients from vulnerable populations than do physician’s offices and trends in their use as a usual source of care have not previously been described.
  
  Study design
  
  Analysis of serial, cross-sectional, nationally representative in-person household surveys, the 1997–2013 National Health Interview Surveys, was conducted to identify children with a usual source of care (n=190,571), and the percentage receiving that care in a clinic. We used Joinpoint regression to identify changes in linear trends, and logistic regression with predictive margins to obtain per-year changes in percentages, both unadjusted and adjusted for sociodemographic factors. Interaction terms in logistic regressions were used to assess whether trends varied by sociodemographic subgroups.
  
  Results
  
  Of all children with a usual source of care, the percentage receiving that care in a clinic declined 0.44 percentage points per year (p<0.001) from 22.97% in 1997 to 19.31% in 2002. Thereafter, it increased approximately 0.57 percentage points per year (p<0.001), reaching 26.1% in 2013. Trends for some sociodemographic subgroups varied from these overall trends. No changes were observed between 2003 and 2013 for non-Hispanic black and Medicaid/SCHIP insured children.
  
  Conclusions
  
  This study shows that, although the percentage of children with a usual source of care in a clinic declined between 1997 and 2002, it has steadily increased since that time.
  
  
• Keywords:
  Adolescent Child Child, Preschool Child Health Services Clinics Cross-Sectional Studies Female Health Care Surveys Health Services Needs And Demand Health Status Humans Infant Infant, Newborn Insurance, Health Male Retrospective Studies Safety Net Socioeconomic Factors Trends United States

  More +
• Source:
  J Pediatr. 167(6):1409-1414
• Pubmed ID:
  26454575
• Pubmed Central ID:
  PMC4745654
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  167
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:01695518cdaa503764966ba20276b800ce8bf0807a850f2003c1c421b87e5bb7
• Download URL:
  https://stacks.cdc.gov/view/cdc/37898/cdc_37898_DS1.pdf
• File Type:
  [PDF - 233.13 KB ]