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J Pediatr. 2015 Dec;167(6):1409-14. doi: 10.1016/j.jpeds.2015.09.026. Epub 2015 Oct 9.

Location of Usual Source of Care among Children and Adolescents in the United States, 1997-2013.

Author information

1
Infant, Child, and Women's Health Statistics Branch, Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD.
2
Department of Pediatrics, Sinai Hospital of Baltimore, Baltimore, MD.
3
Department of Research, American Academy of Pediatrics, Elk Grove Village, IL.

Abstract

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.

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 < .001) from 22.97% in 1997 to 19.31% in 2002. Thereafter, it increased approximately 0.57 percentage points per year (P < .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/State Children's Health Insurance Program 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.

PMID:
26454575
PMCID:
PMC4745654
DOI:
10.1016/j.jpeds.2015.09.026
[Indexed for MEDLINE]
Free PMC Article

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