title: Predictors of delayed or forgone needed health care for families with children.
abstract: BACKGROUND
  We sought to determine how health care-related financial burden, childhood activity limitations, health insurance, and other access-related factors predict delayed or forgone care for families with children, using a nationally representative, population-based sample.
  
  
  METHODS
  Our sample included families with children aged 0 to 17 years whose family was interviewed about their health care expenditures in 1 of 7 panels of the 2001 to 2008 Medial Expenditure Panel Survey (N = 14 138). Financial burden was defined as (1) the sum of out-of-pocket health service expenditures during the first survey year and (2) that sum divided by adjusted family income. Delayed or forgone care was defined as self-report of delayed or forgone medical care or prescription medications for the reference parent or child during the second survey year.
  
  
  RESULTS
  Financial burden, discordant insurance, and having a child with an activity limitation were some of the strongest predictors of delayed or forgone care. Additionally, significant health insurance and income-related disparities exist in the experience of delayed or forgone care.
  
  
  CONCLUSIONS
  Children and their families are delaying or forgoing needed care due to health care-related financial burden. Policies are needed to effectively reduce financial burden and improve the concordance of insurance between parents and children because this may reduce the frequency of unmet need among families. Moreover, reducing the occurrence of delayed or forgone care may improve health outcomes by increasing the opportunity to receive timely and preventive care.
authors.affiliation: Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI 53726, USA.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Wisk
authors.forename: Whitney P
authors.initials: WP
authors.lastname: Witt
mesh_terms: D000293:Adolescent; D015984:Causality; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D019988:Children with Disabilities; D005191:Family Characteristics; D005192:Family Health / Q000191:economics*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics*; D006302:Health Services Research; D054625:Healthcare Disparities / Q000191:economics*; D006801:Humans; D007182:Income; D007223:Infant; D019458:Insurance Coverage / Q000191:economics*; D007348:Insurance, Health / Q000191:economics*; D008297:Male; D055118:Medication Adherence; D020380:Needs Assessment / Q000191:economics*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D014481:United States