Public "safety net" medical services — such as community health centers, public hospitals, migrant worker health centers and primary-care programs in public housing — play a crucial role in providing health care to uninsured children in the United States.
That’s the finding of a Rand Corp. study in the March issue of Pediatrics.
The study of more than 2,600 uninsured children, aged 2 to 17, who lacked insurance for at least one full calendar year at some time from 1996 to 2000, found that children in rural areas were more likely to receive medical services if they lived closer to safety net medical providers or if there were more primary-care doctors nearby.
Living longer distances from safety net providers was associated with fewer doctor visits and fewer health services for uninsured children in rural areas.
"Whether it is the time a parent has to take away from work or the cost of transportation, it’s clear that in rural areas distance between home and a health-care provider is an obstacle for uninsured children," study author and Rand economist Carole Roane Gresenz said in a prepared statement.
The researchers also found that urban children were more likely to receive medical care if they lived in areas where safety net providers were better funded and where there were some primary-care doctors.
"The medical safety net really matters to uninsured children. No matter how much we try to improve the availability of insurance for children, some will inevitably remain uninsured. How we fund and how we structure the safety net influences whether these uninsured kids have access to health care," Gresenz said.
Of the 2,600 uninsured children in the study, 60 percent had no doctor visits during the preceding year and slightly less than half received no health services of any kind.
Previous research has found that nearly 75 percent of privately insured children and more than two-thirds of publicly insured children had at least one doctor visit, and more than 80 percent of privately and publicly insured children had at least some medical expenditures.
