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Usual Place for Sick Care

Narrative

Having a usual place or source of health care is an important indicator of care continuity that has been linked to improvements in care quality, preventive care utilization, and health status.1 In 2010, the majority of children were reported by their parents to have a usual place of health care when they are sick or need of health advice (95.1 percent); however, about a quarter of uninsured children (25.4 percent) did not have a usual place of care.

Receiving regular primary and preventive care in a doctor's office or clinic can help to avoid unnecessary hospitalizations and emergency room visits. In 2010, among children with a usual source of care, 74.3 percent of children used a doctor's office or health maintenance organization (HMO) as their usual place of care, 23.6 percent used a clinic or health center, and 2.1 percent usually used other places, including emergency rooms and hospital outpatient departments; however, this varied greatly by poverty status. Children with household incomes below the poverty level were more than three times as likely to use a clinic or health center as a usual source of care than children living at 400 percent or more of poverty (38.4 versus 12.3 percent). Conversely, 86.9 percent of children living at 400 percent or more of poverty used a doctor's office or HMO as a usual source of care, compared to 58.5 percent of children living in households with incomes below the poverty threshold.

The location where children usually received care also varied by race and ethnicity and insurance type and status. Clinics and health centers were more likely to serve as a usual place of care for American Indian/Alaska Native (52.9 percent), Native Hawaiian/Other Pacific Islander (45.1 percent), and Hispanic children (39.0 percent) compared to about 25 percent or less of children of other racial/ethnic groups (data not shown in graph images or in data tables on this site). Despite being rare overall, about one-tenth (9.5 percent) of uninsured children usually relied on hospital emergency and outpatient departments and other sources of care.

1 Starfield B. Primary Care: Balancing Health Needs, Services, and Technology. New York, NY: Oxford University Press; 1998

Graphs

This image is described in the Data section.

place of physician contact by poverty and race graph

This image is described in the Data section.

place of physician contact by poverty and race graph

Data

Usual Place of Care* Among Children Under Age 18, by Insurance Type and Status, 2010
Insurance Type Percent of Children
Yes No
*Has a place where the child is usually taken when sick or in need of health advice; all estimates are age-adjusted.
Source: Bloom B, Cohen RA, Freeman G. Summary health statistics for U.S. children: National Health Interview Survey, 2010. National Center for Health Statistics. Vital Health Stat 10(250). 2011.
Total 95.1 4.9
Private Insurance 97.5 2.5
Public Insurance 96.2 3.8
Uninsured 74.6 25.4
Location of Usual Place of Care* Among Children Under Age 18, by Poverty Status,** 2010
Poverty Status Percent of Children
Doctor's Office or HMO Clinic or Health Center Hospital or Other Place†

*The place where the child is usually taken when sick or in need of health advice; all estimates are age-adjusted; percentages may not total to 100 due to rounding.
**Poverty level, defined by the U.S. Census Bureau, was $22,314 for a family of four in 2010.
†Includes emergency room, hospital outpatient department, some other place, and not using one place most often.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics. 2010 National Health Interview Survey with multiply imputed poverty data. Unpublished estimates. Analyzed by the Maternal and Child Health Bureau.

Total 74.3 23.6 2.1
Less Than 100% of Poverty 58.5 38.4 3.2
100-199% of Poverty 67.5 29.2 3.2
200-399% of Poverty 79.6 18.9 1.6
400% or More of Poverty 86.9 12.3 0.8