Healthcare services accessibility of children in the USA

Abstract

The increase in the number of children without access to healthcare services is an increasingly urgent issue in the United States. By using data from the Community Tracking Study Household Survey 1996 to 1997, we focus this study on the determinants that cause for the widening gap of healthcare service accessibility among children, 18 years and under, in the USA. Our empirical results suggest that factors such as the out-of-pocket price of healthcare services, household income, years of education by parent (or guardian), health insurance coverage, access to healthcare provider (availability of regular provider, obtaining an appointment, and travelling time) and provider–patient interaction strongly determine the actual use of outpatient services by children as realized access (i.e. accessibility).

Acknowledgements

We are indebted to Michael Grossman and John D. Worrall. We also gratefully acknowledge the research support from the Research Council of Rutgers University, the State University of New Jersey (Grant #202188), Grant-in-Aid Scientific Research (C), from Japan Society for the Promotion of Science (grant number 14530042 and 17530170), and Pfizer Health Research Foundation. The views presented here are those of the authors and do not necessarily represent those of the supporting agencies nor those of the affiliated institutions. Finally, we wish to thank Clayton Cook for his research assistance at Rutgers University, the State University of New Jersey, USA.

Notes

¹ The income effect is {T _HSU [−wV ₂₁ + (1 − θ)p _HS V ₁₁]/D} < 0 and the substitution effect is [λw(1 − θ)p _HS/D] > 0, where D = a _HSU|J| > 0.

² −0.07 ≅ −0.0028(83.276/3.3030). For other age groups, the price elasticity is −0.08 for the 0–5 and 6–11 age groups, and it is −0.05 for the 12–17 age group.