Access Gaps among Uninsured Children in Los Angeles County

Access Gaps Among Uninsured Children in Los Angeles County:Baseline Findings from the 2002/2003 Los Angeles County Health SurveyPrepared for: Prepared by: Genevieve KenneyJoshua McFeetersJustin YeeOctober 3, 2006Children’s Health Initiative of Greater Los Angeles Access Gaps Among Uninsured Children in Los Angeles County:A Baseline Analysis with the 2002/2003 Los Angeles County Health SurveyiAccess Gaps Among Uninsured Children in Los Angeles County:A Baseline Analysis with the 2002/2003 Los Angeles County Health SurveyResultsHealth Access Measures for Low-Income,Uninsured Children• Health Services. Nearly one-third of surveyrespondents did not see a doctor for neededcheck-ups and 30 percent did not go for illness because of cost concerns. However, anypreventive care is an encouraging sign.• Usual Source of Care.Nearly one-third didnot have a regular health care provider. Of thosewho had a provider, most were very satisfied.• Prescription Drugs. One-quarter did notreceive needed medicine.• Dental Care. More than half did not go to the dentist.Access Comparison between Low-Income,Uninsured and Publicly Insured Children• More than 60 percent of uninsured children had difficulty accessing health care comparedto slightly more than 18 percent of publiclyinsured children.• Uninsured children were nearly four times lesslikely to see a doctor for a regular exam thantheir publicly insured counterparts.• Fully 30 percent of uninsured children did notsee a doctor for a health problem compared tojust more than 8 percent with public insurance.• Uninsured children were more than twice aslikely to not get needed prescription medicinesthan those with public insurance.• Children with public coverage were more likely toreceive well-child visits. For example, 95 percentof children age 5 or younger with public coverage had a visit in the past year comparedto 88 percent of uninsured children.Six out of 10 low-income, uninsured children in Los Angeles County had difficultyaccessing needed medical care in 2002/2003. Based on the Los Angeles CountyHealth Survey, it appears that L.A.’s Children’s Health Initiative has the potentialto improve access to health care services for these children if they enroll in publichealth programs.This analysis suggests that children enrolled in the Healthy Kidsprogram would have fewer unmet health and dental needs and would be morelikely to receive well-child and regular care.Executive Summary iiAccess and Use of Low-Income Children Ages 0-17 in L.A. County, Overall and by Key Characteristics, 2002/2003Outcome (Means)Publicly Insured^UninsuredUnmet or delayed health needs1Difficulty accessing needed care for child18.35%60.67%***Unable to afford to see doctor for checkup8.22%30.71%***Unable to afford to see doctor for illness6.98%29.53%***Unable to afford prescription drugs11.18%25.07%***Unable to afford dental care315.00%52.36%***Unable to afford mental health care34.50%11.42%***Any unmet needs due to unaffordability22.30%59.73%***Multiple unmet needs due to unaffordability10.20%38.05%***Transportation barrier to medical care10.33%14.07%**Language barrier to medical care416.99%21.89%*Service Use1Children receiving at least one visit for well-child in past year (0-5)94.97%88.37%*Children receiving at least one visit for well-child in past twoyears (6-17)93.17%79.62%***Usual source of care (USC)1Child has a usual source of care93.54%68.65%***Receipt of health care by children with usual source of care2USC (Usual Source of Care) same place for physical exam94.85%85.12%***USC same place for vaccination95.86%86.60%***Received care at hospital ER21.23%9.06%***Satisfaction with usual source of care2Among children with a usual source of careCaregiver satisfied with health care provided93.77%91.49%Caregiver satisfied with guidance on how to care for child91.97%90.45%Caregiver satisfied with USC helping to understand child growth/development92.01%91.71%Caregiver satisfied with USC being easy to contact by phone88.65%87.73%Caregiver satisfied with USC listening and answering questions92.79%95.54%**Caregiver satisfied with USC scheduling appointments quickly88.06%89.59%Source: Urban Institute tabulations of the 2002/2003 Los Angeles County Health Survey.* p <.1, ** p <.05; ** p <.01Notes:^ denotes reference category.1The sample size is 1739 for Publicly Insured and 491 for Uninsured.2The sample size is 1628 for Publicly Insured and 342 for Uninsured.3Only respondents with a child age 3-17 received these questions. 4Only respondents who were interviewed in a non-English language received this question. Access Gaps Among Uninsured Children in Los Angeles County:A Baseline Analysis with the 2002/2003 Los Angeles County Health SurveyAcknowledgementsThe authors appreciated the assistance provided by Susie Baldwin, Amy Lightstone,Gigi Mathew, and Cheryl Wold at the Los Angeles County Department of PublicHealth and the suggestions of Ian Hill of the Urban Institute, Michael Cousineau ofUniversity of Southern