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America's Children: Key National Indicators of Well-Being, 2017

Usual Source of Health Care

Children's health depends at least partially on their access to health services. Health care for children includes physical examinations, preventive care, health education, observations, screening, immunizations, and sick care.49 Having a usual source of care—a particular person or place a child goes to for sick and preventive care—facilitates the timely and appropriate use of pediatric services.50, 51 Emergency rooms are excluded here as a usual source of care because their focus on emergency care generally excludes the continuity and types of health care mentioned above.52

HC2: Percentage of children ages 0–17 with no usual source of health care by type of health insurance, 1993–2015
Indicator HC2: Percentage of children ages 0–17 with no usual source of health care by type of health insurance, 1993–2015

NOTE: Children with both public and private insurance coverage are placed in the private insurance group. Usual source of health care is based on the following question: "Is there a place that [child's name] USUALLY goes when [he/she] is sick or needs advice about [his/her] health?" A follow-up question specifies that these places may be a walk-in clinic, doctor's office, clinic, health center, health maintenance organization (HMO), outpatient clinic, or military or Veterans Administration health care facility. Emergency rooms are excluded as a usual source of care. A break is shown in the lines because in 1997 the National Health Interview Survey was redesigned. Data for 1997–2015 are not strictly comparable with earlier data.

SOURCE: National Center for Health Statistics, National Health Interview Survey.

  • In 2015, about 4 percent of children ages 0–17 had no usual source of health care.
  • Between 1993 and 2015, the percentage of insured children without a usual source of care declined. In contrast, there was no statistically significant difference in the percentage of uninsured children without a usual source of care between 1993 (24 percent) and 2015 (29 percent).
  • Uninsured children are much more likely to have no usual source of care than children who have health insurance. In 2015, 29 percent of children who were uninsured had no usual source of health care. This was more than 26 percentage points higher than the percentage of children with private health insurance who had no usual source of health care (2 percent) and more than 24 percentage points higher than the percentage of children with public health insurance (including Medicaid) who had no usual source of health care (4 percent).
  • Overall, older children were more likely than younger children to lack a usual source of care among those with public coverage (3 percent of children ages 0–5 compared to 5 percent of those ages 6–17) and no coverage (18 percent versus 32 percent).

table icon HC2 HTML Table

49 Green, M. (Ed.). (1994). Bright futures: Guidelines for health supervision of infants, children, and adolescents. Arlington, VA: National Center for Education in Maternal and Child Health.

50 Simpson, G., Bloom, B., Cohen, R. A., & Parsons, P. E. (1997). Access to health care. Part 1: Children. Vital and Health Statistics, 10 (Series 196). Hyattsville, MD: National Center for Health Statistics.

51 Bartman, B. A., Moy, E., & D'Angelo, L. J. (1997). Access to ambulatory care for adolescents: The role of a usual source of care. Journal of Health Care for the Poor and Underserved, 8, 214–226.

52 Folton, G. L. (1995). Critical issues in urban emergency medical services for children. Pediatrics, 96 (2), 174–179.