Lack of a regular source of care among children using a public hospital emergency department

Area of Science:

• Pediatrics
• Public Health
• Health Services Research

Background:

• Lack of a regular source of care is linked to reduced healthcare service utilization and preventive care for children.
• Urban emergency departments often serve as primary care access points for underserved populations.

Purpose of the Study:

• To identify risk factors associated with children lacking a regular source of care among those presenting for non-appointment care at an urban public hospital.
• To inform strategies for improving consistent healthcare access for pediatric populations.

Main Methods:

• A cross-sectional survey was administered to children under 16 years old attending an urban public hospital's emergency department over a 7-day period.
• Univariate and multivariate logistic regression analyses were employed to determine significant risk factors.

Main Results:

• Out of 791 interviews, 52% of preschool and 66% of school-aged children lacked a regular source of care.
• Children without consistent care were more likely to present with nonurgent conditions (P < 0.0005).
• Multivariate analysis identified older child age (OR=1.6), lack of insurance (OR=1.47), and absence of a personal vehicle (OR=1.44) as significant factors.

Conclusions:

• A majority of children utilizing the urban emergency department lacked a regular source of care.
• While no single factor predicted this, older age and lack of insurance were notable associations.
• Addressing this requires a multifaceted approach, including reducing financial barriers to consistent healthcare access.