Timely access to quality health care among Georgia children ages 4 to 17 years.

Abstract

We examined factors associated with children's access to quality health care, a major concern in Georgia, identified through the 2010 Title V Needs Assessment. Data from the 2007 National Survey of Children's Health were merged with the 2008 Area Resource File and Health Resources and Services Administration medically underserved area variable, and restricted to Georgia children ages 4-17years (N=1,397). The study outcome, access to quality health care was derived from access to care (timely utilization of preventive medical care in the previous 12months) and quality of care (compassionate/culturally effective/family-centered care). Andersen's behavioral model of health services utilization guided independent variable selection. Analyses included Chi-square tests and multinomial logit regressions. In our study population, 32.8% reported access to higher quality care, 24.8% reported access to moderate quality care, 22.8% reported access to lower quality care, and 19.6% reported having no access. Factors positively associated with having access to higher/moderate versus lower quality care include having a usual source of care (USC) (adjusted odds ratio, AOR:3.27; 95% confidence interval, 95% CI 1.15-9.26), and special health care needs (AOR:2.68; 95% CI 1.42-5.05). Lower odds of access to higher/moderate versus lower quality care were observed for non-Hispanic Black (AOR:0.31; 95% CI 0.18-0.53) and Hispanic (AOR:0.20; 95% CI 0.08-0.50) children compared with non-Hispanic White children and for children with all other forms of insurance coverage compared with children with continuous-adequate-private insurance. Ensuring that children have continuous, adequate insurance coverage and a USC may positively affect their access to quality health care in Georgia.