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Nonfinancial barriers to care for children and youth
1Child and Family Health Program, School of Public Health, University of California Los Angeles 90024-1772, USA.
Insights
Fragmented healthcare systems fail to meet children's unique needs, leading to unmet health and developmental needs. Integrating medical, educational, and social services is crucial for improving child health outcomes.
Area of Science:
- Child Health
- Public Health Systems
- Healthcare Delivery
Background:
- Child health has improved due to public health and medical interventions.
- Emerging morbidities like behavioral disorders and child abuse indicate a fragmented health system.
- Children's unique vulnerabilities are often overlooked in healthcare organization and delivery.
Purpose of the Study:
- To analyze barriers to healthcare utilization for children using the Andersen and Aday model.
- To identify the mismatch between the current healthcare system and children's needs.
- To advocate for integrated service models for improved child health outcomes.
Main Methods:
- Utilized the Andersen and Aday model of healthcare utilization.
- Examined financial and nonfinancial barriers related to family and system characteristics.
- Analyzed case studies on immunization, chronic childhood illness, and mobile populations.
Main Results:
- Identified significant financial and nonfinancial barriers to accessing care for children.
- Revealed a systemic mismatch between healthcare services and the basic health requirements of children.
- Highlighted the need for coordinated services for high-risk children and families.
Conclusions:
- Integrated service models are essential for coordinating medical, developmental, educational, and social services.
- Universal, coordinated public health and medical services are necessary for all children.
- Market and health system reforms are needed to ensure adequate healthcare for children.
Abstract:
Public health and medical care interventions have produced dramatic changes in the health of children in the United States. Emerging new morbidities such as behavioral and learning disorders, and child abuse and neglect, highlight the lack of an integrated system of health. Children's developmental vulnerability, dependency, and unique morbidities have been underemphasized in the organization and delivery of health care. The Andersen and Aday model of health care utilization is used to describe financial and nonfinancial barriers to care for children that include family characteristics and organizational characteristics of the health system. Case studies of immunization delivery, children with chronic illness, and mobile populations of children reveal the mismatch between the health care system and children's basic health needs. Integrated service models for high-risk populations of children represent an essential mechanism for coordinating the delivery of medical, developmental, educational, and social services needed by children and families. Universal, coordinated public health and medical services of adequate scope and quality should be assured for children through market and health system reform.