Health Care Utilization and Family Frustration: Do Health Insurance Coverage and Medical Homes for US Children Matter?

Objective: To examine the association of health services utilization and family frustration in getting health care services with the intersection of consistent and adequate health insurance coverage and access to medical home care among children in the US.

Methods: We conducted a pooled, cross-sectional data analysis using the 2016-2023 National Survey of Children's Health data. Survey-weighted multivariable logistic regressions were used to estimate the association of emergency department (ED) visits, preventive care utilization, and family frustration in getting services with the intersection of having consistent and adequate health insurance coverage and comprehensive access to medical home care.

Results: Of 279,789 children representing 61.9 million children from 2016 to 2023, 79.0% had one or more preventive care visits, 17.9% had at least one ED visit, and 18.7% of families reported being frustrated in efforts to get care for their children in the past 12 months. Overall, 33.1% of children were consistently and adequately insured and had access to medical home care, while 21.0% had neither. Compared to children with consistent and adequate health insurance coverage and access to a medical home, children without either or both consistent and adequate health insurance coverage and access to medical home care were less likely to have at least one preventive care visit and, their families were more likely to report frustration in obtaining services.

Conclusion For Practice: Improving access to medical home care is critical to minimize disparities in preventive care use and to improve health outcomes for children, beyond comprehensive health insurance coverage.