TY - JOUR
T1 - The case for synergy between a usual source of care and health insurance coverage
AU - Devoe, Jennifer E.
AU - Tillotson, Carrie J.
AU - Lesko, Sarah E.
AU - Wallace, Lorraine S.
AU - Angier, Heather
N1 - Funding Information:
Funding Sources: This project was directly supported by grants 1 K08 HS16181 and 1 R01 HS018569 from the Agency for Healthcare Research and Quality (AHRQ) and the Oregon Health & Science University Department of Medicine. This publication received indirect support, from the Oregon Clinical and Translational Research Institute (OCTRI), grant number UL1 RR024140 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research.
PY - 2011/9
Y1 - 2011/9
N2 - Background: In 2010, the United States (US) passed health insurance reforms aimed at expanding coverage to the uninsured. Yet, disparities persist in access to health care services, even among the insured. Objective: To examine the separate and combined association between having health insurance and/or a usual source of care (USC) and self-reported receipt of health care services. Design/Setting: Two-tailed, chi-square analyses and logistic regression models were used to analyze nationally representative pooled 2002-2007 data from the Medical Expenditure Panel Survey (MEPS). Participants: US adults (≥18 years of age) in the MEPS population who had at least one health care visit and who needed any care, tests, or treatment in the past year (n = 62,067). MAIN OUTCOME MEASURES: We assessed the likelihood of an adult reporting unmet medical needs; unmet prescription needs; a problem getting care, tests, or treatment; and delayed care based on whether each individual had health insurance, a USC, both, or neither one. KEY RESULTS: Among adults who reported a doctor visit and a need for services in the past year, having both health insurance and a USC was associated with the lowest percentage of unmet medical needs, problems and delays in getting care while having neither one was associated with the highest unmet medical needs, problems and delays in care. After adjusting for potentially confounding covariates (age, race, ethnicity, employment, geographic residence, education, household income as a percent of federal poverty level, health status, and marital status ), compared with insured adults who also had a USC, insured adults without a USC were more likely to have problems getting care, tests or treatment (adjusted relative risk [aRR] 1.27; 95% confidence interval [CI] 1.18-1.37); and also had a higher likelihood of experiencing a delay in urgent care (aRR 1.12; 95% CI 1.05-1.20). CONCLUSIONS: Amidst ongoing health care reform, these findings suggest the important role that both health insurance coverage and a usual source of care may play in facilitating individuals' access to care.
AB - Background: In 2010, the United States (US) passed health insurance reforms aimed at expanding coverage to the uninsured. Yet, disparities persist in access to health care services, even among the insured. Objective: To examine the separate and combined association between having health insurance and/or a usual source of care (USC) and self-reported receipt of health care services. Design/Setting: Two-tailed, chi-square analyses and logistic regression models were used to analyze nationally representative pooled 2002-2007 data from the Medical Expenditure Panel Survey (MEPS). Participants: US adults (≥18 years of age) in the MEPS population who had at least one health care visit and who needed any care, tests, or treatment in the past year (n = 62,067). MAIN OUTCOME MEASURES: We assessed the likelihood of an adult reporting unmet medical needs; unmet prescription needs; a problem getting care, tests, or treatment; and delayed care based on whether each individual had health insurance, a USC, both, or neither one. KEY RESULTS: Among adults who reported a doctor visit and a need for services in the past year, having both health insurance and a USC was associated with the lowest percentage of unmet medical needs, problems and delays in getting care while having neither one was associated with the highest unmet medical needs, problems and delays in care. After adjusting for potentially confounding covariates (age, race, ethnicity, employment, geographic residence, education, household income as a percent of federal poverty level, health status, and marital status ), compared with insured adults who also had a USC, insured adults without a USC were more likely to have problems getting care, tests or treatment (adjusted relative risk [aRR] 1.27; 95% confidence interval [CI] 1.18-1.37); and also had a higher likelihood of experiencing a delay in urgent care (aRR 1.12; 95% CI 1.05-1.20). CONCLUSIONS: Amidst ongoing health care reform, these findings suggest the important role that both health insurance coverage and a usual source of care may play in facilitating individuals' access to care.
KW - access to health care
KW - health care reform
KW - health insurance
KW - health policy
KW - usual source of care
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U2 - 10.1007/s11606-011-1666-0
DO - 10.1007/s11606-011-1666-0
M3 - Article
C2 - 21409476
AN - SCOPUS:80052295956
SN - 0884-8734
VL - 26
SP - 1059
EP - 1066
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
IS - 9
ER -