title: Factors associated with parent report of access to care and the quality of care received by children 4 to 17 years of age in Georgia.
abstract: We examined factors associated with health care access and quality, among children in Georgia. Data from the 2007 National Survey of Children's Health were merged with the 2008 Area Resource File. The medically underserved area variable was appended to the merged file, restricting to Georgia children ages 4-17 years (N = 1,397). Study outcomes were past-year access to care, defined as utilization of preventive medical care and no occasion of delay or denial of needed care; and quality of care received, defined as compassionate, culturally-effective, and family-centered care which was categorized as higher, moderate, or lower. Analysis included binary and multinomial logit modeling. In our study population, 80.8 % were reported to have access to care. The quality of care distribution was: higher (39.4 %), moderate (30.6 %), and lower (30.0 %). Younger age (4-9 years) was positively associated with having access to care. Compared to children who had continuous and adequate private insurance, children who were never/intermittently insured or who had continuous and inadequate private insurance were less likely to have access. Compared to children who had continuous and adequate private insurance, there were lower odds of perceiving received care as higher/moderate versus lower quality among children who were never/intermittently insured or who had continuous and inadequate/adequate public insurance. Being in excellent/very good health and living in safe/supportive neighborhoods were positively associated with quality; non-white race/ethnicity and federal poverty level were negatively associated with quality. Assuring continuous, adequate insurance may positively impact health care access and quality.
authors.affiliation: Division of Public Health, Georgia Department of Community Health, Atlanta, GA, USA. chogbuanu@dhr.state.ga.us
authors.forename: Chinelo
authors.initials: C
authors.lastname: Ogbuanu
authors.forename: David
authors.initials: D
authors.lastname: Goodman
authors.forename: Katherine
authors.initials: K
authors.lastname: Kahn
authors.forename: Brendan
authors.initials: B
authors.lastname: Noggle
authors.forename: Cherie
authors.initials: C
authors.lastname: Long
authors.forename: Suparna
authors.initials: S
authors.lastname: Bagchi
authors.forename: Danielle
authors.initials: D
authors.lastname: Barradas
authors.forename: Brian
authors.initials: B
authors.lastname: Castrucci
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000458:organization & administration*; D005191:Family Characteristics; D005260:Female; D005845:Georgia; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D054625:Healthcare Disparities; D006801:Humans; D007182:Income; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D015995:Prevalence; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000592:standards*; D012111:Residence Characteristics; D012931:Social Environment; D012959:Socioeconomic Factors