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:
  • clinics
  • safety net
  • trends
  • Adolescent
  • Child
  • Child Health Services
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Health Care Surveys
  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
• Download URL:
  https://stacks.cdc.gov/view/cdc/37898/cdc_37898_DS1.pdf
• File Type:
  [PDF - 233.13 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:01695518cdaa503764966ba20276b800ce8bf0807a850f2003c1c421b87e5bb7