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America's Children: Key National Indicators of Well-Being, 2013

Usual Source of Health Care

The health of children depends at least partially on their access to health services. Health care for children includes physical examinations, preventive care, health education, observations, screening, immunizations, and sick care.42 Having a usual source of care—a particular person or place a child goes to for sick and preventive care—facilitates the timely and appropriate use of pediatric services.43, 44 Emergency rooms are excluded here as a usual source of care because their focus on emergency care generally excludes the other elements of health care.45

Indicator HC2: Percentage of children ages 0–17 with no usual source of health care by type of health insurance, 1993–2011
Percentage of children ages 0–17 with no usual source of health care by type of health insurance, 1993–2011

NOTE: Children with both public and private insurance coverage are placed in the private insurance group. Emergency rooms are excluded as a usual source of care. A break is shown in the lines because in 1997 the National Health Interview Survey (NHIS) was redesigned. Data for 1997–2011 are not strictly comparable with earlier data.

SOURCE: National Center for Health Statistics, National Health Interview Survey.

  • In 2011, about 4 percent of children had no usual source of health care.
  • Uninsured children are much more likely to have no usual source of care than are children who have health insurance. For example, 28 percent of children who were not insured had no usual source of health care. This was more than 18 times the percentage of children with private health insurance who had no usual source of health care (1.5 percent).
  • There are differences in the percentage of children having no usual source of care by type of health insurance coverage. In 2011, children with public insurance, such as Medicaid, were more likely to have no usual source of care than were children with private insurance (3 and 2 percent, respectively).
  • In 2011, about 6 percent of children living below the poverty level and 6 percent of children living in families with incomes 100–199 percent of the poverty level had no usual source of health care, compared with 2 percent of children with family incomes 200 percent or more of the poverty level.
  • Older children are more likely than younger children to lack a usual source of health care. In 2011, approximately 5 percent of children ages 6–17 had no usual source of care, compared with 3 percent of children ages 0–5.

table icon HC2 HTML Table

42 Green, M. (Ed.). (1994). Bright futures: Guidelines for health supervision of infants, children, and adolescents. Arlington, VA: National Center for Education in Maternal and Child Health.

43 Simpson, G., Bloom, B., Cohen, R.A., and Parsons, P.E. (1997). Access to health care. Part 1: Children. Vital and Health Statistics, 10(Series 196). Hyattsville, MD: National Center for Health Statistics.

44 Bartman, B.A., Moy, E., and D'Angelo, L.J. (1997). Access to ambulatory care for adolescents: The role of a usual source of care. Journal of Health Care for the Poor and Underserved, 8, 214–226.

45 Folton, G.L. (1995). Critical issues in urban emergency medical services for children. Pediatrics, 96(2), 174–179.