Medical books for children12/24/2022 ![]() Data are from the National Health Interview Survey, supplemented by informationcollected from vaccination providers in the National Immunization (more.) Vaccinations against selected diseases for children ages 19-35 monthsby poverty status, United States, 1994. The rates are based on data from 10 states with a total population of 95 million analyzed by the Ambulatory Care Access Project of the United Hospital Fund of New York (Center for Health Economics Research, 1993, p. The increased levels of risk for newborns were thought likely to be due in part to the lack of access to prenatal care for the uninsured mothers, who were also more likely to be black and Hispanic.įigure 3.2 and Table 3.1 present the rates of hospitalizations for children whose conditions could have been treated on an outpatient basis (also known as "ambulatory care-sensitive conditions" or "preventable hospitalizations"). While each of these factors independently predicted the hospitalization rates, they were also significantly interrelated.Ī California study found that newborns who were uninsured were more likely to be sick but received fewer services in the hospital than newborns who had insurance coverage (Braveman et al., 1989). The study also found that hospitalization and mortality rates were highest in the poorest neighborhoods included in the study and in neighborhoods with the highest percentage of black and Hispanic residents. The uninsured children were more likely to be admitted to the hospital in a critical condition, and their needs for care were more urgent on admission. Among children hospitalized in New York City for similar problems, one study found an inhospital death rate that was almost one and one-half (1.46) times higher for uninsured children than for those who were insured (Carr et al., 1992). Insured children have been found to have better outcomes from hospitalizations than uninsured children. ![]() This chapter reviews scientific and empirical evidence on the financial and nonfinancial influences represented in the first column of the figure. It presents the overall framework used by the committee to approach its analysis of a variety of influences on access to health care. The chapter also presents three approaches to defining what kinds of health care services should be provided for children, and then describes the services allowed under the State Children's Health Insurance Program (SCHIP).įigure 3.1 was developed by the committee and revised several times throughout the course of the study. Next, other financial and nonfinancial barriers to care are discussed, including family income family structure and racial, ethnic, and cultural factors. This chapter begins with a general discussion of the evidence that health insurance affects children's access to health care, emphasizing differences in health care utilization rates for insured and uninsured children. The most common way to measure access is by comparing the health care utilization rates for different age groups, different racial and ethnic groups, and so on. The Institute of Medicine (IOM) has defined access as ''the timely use of personal health services to achieve the best possible health outcomes" (IOM, 1993, p. When children fail to receive necessary health care, their lives and the lives of their families can be affected for many years. All children are at increased risk of developing preventable conditions if appropriate care is not provided when they are sick or injured. ![]() Health care can influence children's physical and emotional health, growth, and development and their capacity to reach their full potential as adults. Children's access to health care is important to children themselves, to their families, as well as to society at large.
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