Table 2. Unadjusted Prevalence and Adjusted Trends for Children’s Health Care Access and Service Utilization, 2016-2020 (N = 174 551).
| Weighted prevalence, % (95% CI)a | 5-y Trends (2016-2020) | Before COVID-19 (2016-2019) | COVID-19 era (2020 vs 2019) | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2016 (n = 50 212) | 2019 (n = 29 433) | 2020 (n = 42 777) | ||||||||||
| Absolute difference | Relative difference | P value for trend (adj)b | Absolute difference | Relative difference | P value for trend (adj)b | Absolute difference | Relative difference | P value for trend (adj)b | ||||
| Health care access | ||||||||||||
| Currently uninsured | 6.1 (5.5-6.7) | 6.8 (6.1-7.6) | 7.2 (6.6-7.9) | 1.2 | 19.0 | .004 | 0.7 | 12.1 | .06 | 0.4 | 6.2 | .36 |
| Adequate and continuous health insurance | 69.4 (68.4-70.3) | 66.0 (64.8-67.2) | 67.4 (66.4-68.4) | −2.0 | −2.9 | .004 | −3.4 | −4.9 | <.001 | 1.4 | 2.1 | .06 |
| Problems paying child’s medical bills, past 12 mo | 15.6 (14.8-16.4) | 17.0 (15.9-18.2) | 13.7 (12.9-14.6) | −1.9 | −12.1 | .25 | 1.4 | 9.1 | .047 | −3.3 | −19.5 | <.001 |
| Unmet needs for health care, past 12 mo | 3.0 (2.6-3.3) | 3.1 (2.6-3.6) | 4.0 (3.5-4.6) | 1.1 | 36.2 | .004 | 0.1 | 3.4 | .58 | 1.0 | 31.8 | .007 |
| Frustrated in getting services for child, past 12 mo | 17.0 (16.2-17.8) | 18.0 (17.0-19.0) | 17.3 (16.5-18.2) | 0.3 | 1.9 | .15 | 1.0 | 6.1 | .14 | −0.7 | −3.9 | .32 |
| Usual source of sick care | 79.7 (78.7-80.6) | 75.9 (74.7-77.1) | 74.7 (73.7-75.7) | −5.0 | −6.3 | <.001 | −3.8 | −4.7 | <.001 | −1.2 | −1.6 | .07 |
| Health service utilization (past 12 mo) | ||||||||||||
| Preventive medical visit | 78.9 (77.8-80.0) | 81.0 (79.7-82.3) | 74.1 (72.9-75.3) | −4.8 | −6.1 | <.001 | 2.1 | 2.7 | .01 | −6.9 | −8.5 | <.001 |
| Preventive dental visit (1-17 y) | 78.7 (77.8-79.6) | 80.1 (79.0-81.2) | 74.9 (73.9-75.8) | −3.9 | −4.9 | <.001 | 1.4 | 1.8 | .40 | −5.3 | −6.6 | <.001 |
| Specialty care when needed | 88.6 (86.8-90.2) | 87.4 (85.0-89.5) | 87.9 (85.7-89.8) | −0.7 | −0.8 | .19 | −1.3 | −1.4 | .30 | 0.5 | 0.6 | .81 |
| Mental health treatment/counseling when needed (3-17 y) | 82.2 (80.0-84.3) | 82.7 (79.8-85.3) | 79.9 (77.1-82.3) | −2.4 | −2.9 | .74 | 0.5 | 0.6 | .81 | −2.9 | −3.5 | .38 |
| Developmental screening (9-35 mo) | 30.4 (28.0-32.9) | 37.7 (34.0-41.4) | 36.1 (33.2-39.1) | 5.7 | 18.7 | <.001 | 7.2 | 23.7 | .001 | −1.5 | −4.1 | .52 |
Abbreviation: adj, adjusted.
a
See eTable 2 in the Supplement for 2017 and 2018 estimates.
b
Adjusted models controlled for child sex, age, race and ethnicity, and household income.