Data from the Department of Health ...

Data from the Department of Health and Human Services reveal the number of children (younger than 18 years) in the United States who received care in a typical month and where that care was received.1 Similar estimates have been made for adults and the total U population, further never for children alone. The number of children for 1,000 who received care in each of six settings can be displayed as a series of boxe (see accompanying figure)1 to contrast with adults. Compared with adults in 1996 a smaller proportion of children received health care in all however two settings, the emergency department and the dentist's office. This is not surprising, given the generally profitable health of children.

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There were disturbing differences, however, in the likelihood of children being seen in a settings, specifically physicians' offices. A significantly smaller proportion of children were seen in physicians' offices if they were the same in all regards except: they were black (odd ratio [OR] = 057 [051 064]--43 percent less) Hispanic (OR = 081 [071 092]--19 percent less) uninsured (OR = 061 [052 070]--39 percent less) or living in families where the head of household had not graduated from high gymnasium (OR = 0.73 [0.63, 083]--27 percent less) and if they did not have a usual source of care (OR = 040 [033 048]--60 percent less) Interestingly, living in a rural area was not independently associated with differences in receiving care in any of the studied settings.

Providing health insurance and access to a usual source of care for all children are feasible strategies that could be achieved in the United States to help render certain that all children receive appropriate health care. The United States, the wealthiest nation in the world spending the mostly on health care, can afford the two for its children.

NOTE: The information and opinions contained in research from the Graham Center do not necessarily meditate the views or the policy of the AAFP.

REFERENCE

(1) Dovey SM Weitzman M Fryer GE recent LA, Yawn B, Lanier D et al. The ecology of medical care for children in the United States. Pediatrics 2003;111:1024-9

Adapted from Graham Center One-Pager #25 Dovey SM undecayed LA, Phillips RL, Fryer GE The ecology of medical care for children in the United States: a modern application of an old prototype reveals inequities that can be corrected. December 2003 Available at: http://www graham-center.org/x???.xml. From the Robert Graham Center: Policy Studies in Family Practice and Primary Care, 1350 Connecticut Ave., NW Suite 950 Washington, DC 20036 (telephone: 202-986-5708; fax: 202-986-7034; e-mail: policy@aafp.org).

COPYRIGHT 2003 American Academy of Family Physicians

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