Insurance + Access != Health Care: Typology of Barriers to Health Care Access for Low-Income Families
The Annals of Family MedicinePublished 1 November 2007Open access
Jennifer E. DeVoe, Amado Alejandro Báez, Heather Angier, Lisa Krois, Charlotta Edlund, Patricia A. Carney
Citations234
SJR quartileQ1
SJR score1.10
SNIP1.69
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The authors' analyses uncovered a 3-part typology of barriers to health care for low-income families: lack of insurance coverage, poor access to services, and unaffordable costs.
Abstract
Barriers to health care can be insurmountable for low-income families, even those with insurance coverage. Patients who do not seek care in a family medicine clinic are not necessarily getting their care elsewhere.
Keywords
Health ProfessionsEconomics, Econometrics and Finance
Journal of Health and Social BehaviorRevisiting the Behavioral Model and Access to Medical Care: Does it Matter?
9,675 Citations1995Ronald Andersen
The Behavioral Model of Health Services Use was initially developed over 25 years ago and is reviewed and assessed for continued relevance.
PubMedA framework for the study of access to medical care.
2,402 Citations1974Lu Ann Aday, Ronald Andersen
Indicators are suggested for the measurement of the various relevant aspects of access, with the system and population descriptors seen as process indicators and utilization and satisfaction as outcome indicators in a theoretical model of the access concept.
PEDIATRICSThe Medical Home, Access to Care, and Insurance: A Review of Evidence
457 Citations2004Bárbara Starfield, Leiyu Shi
A concerted attempt to provide a means of universal financial access as well as a medical home should be of high priority for the United States.
PEDIATRICSChildren's Access to Primary Care: Differences by Race, Income, and Insurance Status
377 Citations1996Paul W. Newacheck, Dana C. Hughes +1 more
The existence of substantial barriers to the access to and use of primary care for low-income, minority, and uninsured children is cause for significant concern, especially in an era of program cutbacks.
New England Journal of MedicineChildren in the United States with Discontinuous Health Insurance Coverage
272 Citations2005Lynn Olson, Suk‐fong S. Tang +1 more
Children with gaps in health insurance coverage commonly do not seek medical care, including preventive visits, and do not get prescriptions filled and point to the need for more encompassing and sensitive measures of the situation of being uninsured.
JAMAInsurance Status and Access to Urgent Ambulatory Care Follow-up Appointments
268 Citations2005Brent R. Asplin
PEDIATRICSDental Screening and Referral of Young Children by Pediatric Primary Care Providers
236 Citations2004Georgia G. Dela Cruz, R. Gary Rozier +1 more
Investigation of characteristics of medical providers that influence their referral to a dentist of children who are at risk for dental disease found that providers who had high confidence in their ability to perform screenings and reported low overall referral difficulty were more likely to refer children.
Medical Care Research and ReviewIncome Inequality and Health: A Critical Review of the Literature
209 Citations2003James Macinko, Leiyu Shi +2 more
Future studies will require a more comprehensive model of health production that includes health system covariates, sufficient sample size, and adjustment for inconsistencies in income inequality data.
Health Services ResearchExpanding Public Health Insurance to Parents: Effects on Children's Coverage under Medicaid
143 Citations2003Lisa Dubay, Genevieve Kenney
Children who reside in states that expanded public health insurance programs to parents participate in Medicaid at a rate that is 20 percentage points higher than of those who live in states with no expansions.
PEDIATRICSInequality of Access to Surgical Specialty Health Care: Why Children With Government-Funded Insurance Have Less Access Than Those With Private Insurance in Southern California
124 Citations2004Edward C. Wang, Meeryo Choe +2 more
There is a tremendous inequality of access to surgical specialty health care for children with government-funded insurance when compared with those with commercial insurance in Southern California and Physicians indicate that this disparity is related to excessive administrative burdens and low monetary reimbursement.
The Annals of Family MedicinePrimary Care Physicians' Perceptions of the Effect of Insurance Status on Clinical Decision Making
70 Citations2006David Meyers
Primary care physician’s perceptions of what effect, if any, patients’ insurance status has on their clinical decision making during office visits are characterized to better understand this disparity.
PubMedAccess to health care. Part 1: Children.
69 Citations1997Gloria Simpson, Barbara Bloom +2 more
National estimates of access to medical care and unmet health care needs for children through 17 years of age by selected sociodemographic variables including sex, age, race and/or ethnicity, family income, family structure, place of residence, and health status are presented.
PEDIATRICSChanges in Access, Utilization, and Quality of Care After Enrollment Into a State Child Health Insurance Plan
64 Citations2005Allison Kempe, Brenda L. Beaty +5 more
Families who were newly enrolled into ChP+ perceived dramatic increases in access to all types of care and decreases in unmet medical needs, no increase in utilization of emergency department or hospitalization services, and improved overall quality of care in the year after enrollment into CHP+.
Health AffairsSimplifying Children’s Medicaid And SCHIP
60 Citations2004Karl Kronebusch, Brian Elbel
SCHIP programs administered as Medicaid expansions have been more successful in enrolling children than either separate SCHIP plans or combination programs.
PEDIATRICSFamily Physicians in the Child Health Care Workforce: Opportunities for Collaboration in Improving the Health of Children
54 Citations2006Robert L. Phillips, Andrew Bazemore +3 more
The number of clinicians caring for children meets or exceeds most estimates of sufficiency; however, the workforce distribution is skewed, leaving certain populations and settings underserved.
Health AffairsHow Stable Is Medicaid Coverage For Children?
53 Citations2007Gerry Fairbrother, Heidi P. Emerson +1 more
Examination of Medicaid coverage patterns in five states for children who were covered as of December 2003 found that Medicaid was a source of continuous coverage for sizable proportions of children but a revolving door for others.
The Future of ChildrenWhich Children Are Still Uninsured and Why
47 Citations2003John Holahan, Lisa Dubay +1 more
The authors conclude that the strong economy and concomitant increase in employer-based coverage played a bigger part in reducing uninsurance rates than did expansions in public programs and argue that lack of participation by eligible children rather than inadequate eligibility levels is the key policy issue.
Health AffairsCosts Of Enrolling Children In Medicaid And SCHIP
39 Citations2004Gerry Fairbrother, Melinda J. Dutton +4 more
This study finds that administrative tasks associated with enrollment absorb sizable amounts of funds and could be reduced by approximately 40 percent if documentation requirements were simplified.
Health AffairsChildren’s Ability To Access And Use Health Care
35 Citations2004Sylvia Guendelman, Michelle Pearl
The extent to which child-only and family coverage ensure health care access and use for children in working-poor families is compared and the additional benefits of family coverage over child- only coverage seem less pronounced.
Health Services ResearchUninsurance among Children Whose Parents Are Losing Medicaid Coverage: Results from a Statewide Survey of Oregon Families
32 Citations2007Jennifer E. DeVoe, Lisa Krois +3 more
Uninsured children and those with recent coverage gaps were more likely to have adults in their household who lost Medicaid coverage after recent cutbacks, and states need to be aware of the impact on children when adults lose coverage.
Health AffairsAddressing Coverage Gaps For Low-Income Parents
27 Citations2004Lisa Dubay, Genevieve Kenney
It is found that unins insurance rates have been rising for low-income parents, especially those living in poverty, and that Medicaid and SCHIP could greatly reduce uninsurance among parents and would likely increase their access to care.
New England Journal of MedicineInsurance and the U.S. Health Care System
24 Citations2005Bárbara Starfield
The potent effect of inadequate insurance coverage on several aspects of access to services, including delays in seeking care, unmet medical care needs, unfilled prescriptions, and no visits to doctors' offices are described.
Health AffairsU.S. Child Health: What’s Amiss, And What Should Be Done About It?
24 Citations2004Bárbara Starfield
Adopting the recommendations of a new National Research Council/Institute of Medicine report and some changes in health policy could help improve the health of American children.
PEDIATRICSFamily Reports of Care Denials for Children Enrolled in TennCare
16 Citations2004Robert S. Valet, Diane F. Kutny +2 more
More research is needed to understand the implications of denied care for children and families who are enrolled in Medicaid managed care programs like TennCare, and factors surrounding these denials were identified.
Current Opinion in PediatricsThe impact of Medicaid on children??s healthcare and health
15 Citations2005Patrick M. Vivier
The impact of the Medicaid program is reviewed, including the proportion of children in America insured by Medicaid; the extent to which Medicaid-enrolled children have access to care; the use of services and the quality of care received by Medicaid enrollees; and family satisfaction with the program.
Ambulatory PediatricsWillingness of Eye Care Practices to Evaluate Children and Accept Medicaid
12 Citations2004Alex R. Kemper, Guillermo Diaz +1 more
Findings contradict the perception that eye care for children is unavailable and suggest that larger practice size was associated with increased odds of Medicaid acceptance in both optometry-listed and ophthalmology-listed practices.
PubMedEmployer health insurance premium subsidies unlikely to enhance coverage significantly.
12 Citations2001Reschovsky Jd, J Hadley
Premium subsidies paid directly to small firms are unlikely to significantly reduce the number of uninsured workers, according to a national study by the Center for Studying Health System Change.
