The stability of a usual source of care is important to the care of low-income children

Child/Adolescent Health
The stability of a usual source of care is important to the care of low-income children

Growing children need good, quality health care as they mature into adulthood. This makes having an ongoing relationship with a pediatrician or other primary care provider important. Changes in insurance coverage, however, may make having a usual source of care (USC) difficult at times. A new study suggests that children without a USC and those without a stable USC have greater odds of having one or more unmet health care needs compared with children with a consistent USC.

Jennifer E. DeVoe, M.D., D.Phil., of the Oregon Health and Science University, and colleagues conducted a survey among families living in Oregon and participating in the food stamp program. A total of 2,681 households completed surveys that asked questions about unmet health care needs over the past 12 months. The researchers collected data on their insurance coverage and any USC changes, and compared the Oregon sample with national estimates.

They found that 1 in 10 low-income children in Oregon did not have a current USC, reflecting national trends. Significantly more of these children experienced an unmet health care need compared with children with a USC (79 vs. 45 percent). More than 1 in 5 children participating in the food stamp program had to change their USC for insurance reasons. Such instability in having a USC resulted in these children also having a higher probability of experiencing an unmet health need compared with children with a stable USC. In many cases, their rates of unmet care need were similar to that of children without a USC. According to the researchers, it is not enough for children to simply have a USC. They need to have one over a long period of time where they can establish an ongoing relationship to ensure quality care. The study was supported in part by the Agency for Healthcare Research and Quality (HS14645 and HS16181).

See "A medical home versus temporary housing: The importance of a stable usual source of care," by Jennifer E. DeVoe, M.D., D. Phil., John W. Saultz, M.D., Lisa Krois, M.P.H., and Carrie J. Tillotson, M.P.H., in the November 2009 Pediatrics 124(5), pp. 1363-1371.