NSG 6430 What are the sources of pediatric primary care in the United States?
NSG 6430 What are the sources of pediatric primary care in the United States?
Pediatric Health Care Services
The development of practice models, systems, and training for pediatric care has received significant attention from the literature. The acknowledgement of the important role of child development in the determination of adult capacity has made it critical to establish responsive childhood services system. During such a process, the role of practitioners need to extend beyond the traditional constricts in order to develop a holistic, and more contemporary system. However, even with the development of such system, the sources of pediatric primary care require a similar attention while the barriers to pediatric access to care should become eliminated. All these can only happen through a comprehension of pediatric health care services in the United States. Therefore, the present paper will look to examine these services through the prism of the sources of pediatric care, an appraisal of the status of the pediatric health care services as well as barriers that prevent children from accessing these services in the United States.
Sources of Pediatric Primary Care in the United States
According to Simon et al. (2015),a study conducted between 2011-2012 revealed that only 95.5% of children in the United States possessed a usual source of health care. Further studies on the matter revealed that children with usual sources of primary care in the United States showed a higher probability of receiving health care services such as seeing a physician alongside others. In the pediatric primary care, a trend has emerged where parents take their children to a clinic, health center, and hospital outpatient departments for primary care (Simon et al., 2015). These three sources form the foundational pediatric primary care sources in the United States. In addition to the above, pediatric also receive primary care services from the ER Department, although only to a limited extend.
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However, the above sources fail in the sufficient provision of services to the pediatric population. According to statistics, the pediatric population in the United States continues to grow at a remarkable pace. As such, the existing pediatric health care services do not have the capacity to provide the necessary services. Indeed, this becomes evident when Kuo et al. (2012) asserts that 50% of developmental challenges remain undiagnosed until school-going age. Further, a majority of pediatric patients do not have health care coverage while the fact that a majority of them belong to minority populations, hence from poor socio-cultural backgrounds, implies that they have limited access to the primary sources of care. Thus, the disorganization of the entire system of pediatric health care services means that the sources of primary care do not offer sufficient services.
Pediatric Populations that Lack Access
Minority populations in the United States of America have always struggled to access health care services equitably. Similarly, studies have shown pediatric population of African-American and Latin origins as lacking access to health care services. A study by Koita et al. (2018) revealed that poverty forms the main reason as to why these minority children lack access to heath care services. The prevalence of poverty in their communities prevents them from enjoying resources that can maintain health, which embeds poverty. As a consequence, the poor health prevents their parents and themselves from gainful employment and education that they could use to eradicate poverty. These reasons thus prevent them from getting insurance and affording primary health care services even from their usual sources of care.
Barriers to Children Accessing Health Care
In the United States health care system, barriers related to socioeconomic and racial factors in minority populations have denied children access to pediatric health care services. Fundamentally, the absence of insurance cover has hampered access to care among these populations. According to statistics, over 40 million people in the United States do not have insurance cover, with a majority of them belonging to poor, minority populations. As a result, children from such communities cannot access basic primary care services from clinics, emergency departments, and even health centers (Ray & Mehrotra, 2016). In addition, the quality of care that they receive is of poor quality as a majority of them cannot afford out-of-pocket payments. Moreover, the absence of specific source to ongoing care also prevents children from accessing quality care. The minority populations have demonstrated a higher percentage of the situation as data has consistently revealed that blacks and Hispanic whites have a comparatively lower rates to their non-Hispanic whites. As such, their children do not access quality pediatric primary care services. Lastly, limited proficiency in English has also prevented children from minority populations from accessing quality care. The barriers in language proficiency particularly among the Hispanic whites has exposed them to decreased safety, quality of care and patient and clinician satisfaction. The situation affects these population even for those who may have access to care due to their insurance coverage.
In all the above barriers, the overriding theme entails poverty and illiteracy, which affect a significant portion of these minority populations. The general trend of insurance coverage in the U.S shows that low-income, poor, and middle income have lower percentages compared to high-income populations. Additionally, the level of education also determines insurance coverage as those within more than high school certification demonstrate higher propensity to take cover than those without (Koita et al., 2018). The same trends have been observed in the limited English proficiency and specific source of ongoing care barriers. Therefore, poverty and education form a double-thronged axis for the existence of barriers to primary pediatric health care services.
Pediatric health care services in the United States play a significant role in the realization of the Healthy People 2020 objectives. However, the barriers to quality care caused by socioeconomic and ethnic disparities have exposed pediatric patients to poor care in the U.S. This has ensured that Latino and African-American children do not access pediatric health care services.
Koita, K., Long, D., Hessler, D., Benson, M., Daley, K., Bucci, M., … Burke Harris, N. (2018). Development and implementation of a pediatric adverse childhood experiences (ACEs) and other determinants of health questionnaire in the pediatric medical home: A pilot study. PLoS ONE, 13(12), 1–16. https://doi.org/10.1371/journal.pone.0208088
Kuo, A. A., Etzel, R. A., Chilton, L. A., Watson, C., & Gorski, P. A. (2012). Primary care pediatrics and public health: meeting the needs of today’s children. American journal of public health, 102(12), e17–e23. doi:10.2105/AJPH.2012.301013
Ray, K. N., & Mehrotra, A. (2016). Trends in Access to Primary Care for Children in the United States, 2002-2013. JAMA pediatrics, 170(10), 1023–1025. doi:10.1001/jamapediatrics.2016.0985
Simon, A. E., Rossen, L. M., Schoendorf, K. C., Larson, K., & Olson, L. M. (2015). Location of Usual Source of Care among Children and Adolescents in the United States, 1997-2013. The Journal of pediatrics, 167(6), 1409–1414. doi:10.1016/j.jpeds.2015.09.026