Volume 53 | Number 3 | June 2018
Monica Gentili Ph.D., Pravara Harati, Nicoleta Serban Ph.D., Jean O'Connor J.D., M.P.H., Dr.P.H., Julie Swann Ph.D.
To quantify disparities in accessibility and availability of pediatric primary care by modeling interventions across multiple states that compare publicly insured versus privately insured children, and urban versus rural communities.
Secondary data sources include 2013 National Plan and Provider Enumeration System, 2009 Medicaid claims, 2012 American Community Survey.
The study models accessibility and availability of care for all children in seven states.
Optimization modeling with access constraints is used to estimate access. Statistical hypothesis testing is used to quantify systematic disparities.
California has the best accessibility for privately insured children and Minnesota for publicly insured children. Mississippi has the lowest availability for both populations. Overall, the disparities in availability for pediatric primary care are not as significant as in accessibility. Both rural and urban communities are in need of improvement in accessibility to primary care for publicly insured children, although at varying levels across states.
Disparities in availability are not as significant as disparities in accessibility. Opportunities to improve access to pediatric primary care vary by state. Generating specific recommendations for small areas is critical to enabling health policy decision makers to improvement access.