Published online February 1, 2007
PEDIATRICS Vol. 119 Supplement February 2007, pp. S61-S67 (doi:10.1542/peds.2006-2089J)
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SUPPLEMENT ARTICLE


Factors Associated With Not Having a Personal Health Care Provider for Children in Florida

Mary Beth Zeni, ScDa, William Sappenfield, MD, MPHb, Dan Thompson, MPHb and Hailin Chen, MSb

a College of Nursing, Florida State University, Tallahassee, Florida
b Florida Department of Health, Family Health Services Division, Tallahassee, Florida

OBJECTIVE. National recommendations by the American Academy of Pediatrics and the National Association of Pediatric Nurse Practitioners promote that all children obtain quality primary care through a consistent medical provider who can better assess, diagnose, and monitor a child's health. The purpose of this article was to identify characteristics of children in Florida without a personal health care provider.

METHODS. Florida data (N = 2116) from the 2003 National Survey of Children's Health were analyzed by using bivariate and multivariate methods. The dependent, or outcome, variable was a personal health care provider, defined in the National Survey of Children's Health as a personal doctor or nurse.

RESULTS. In Florida, 20.1% of children (0–17 years of age) do not have a personal health care provider compared with 16.7% in the United States. Children at greatest risk are those without health insurance. Other significant risk factors include family poverty up to 100% of federal poverty level, poverty level 100% to 199%, poverty level unknown, poverty level 200% to 399%, children aged 5 to 12 years, children aged 13 to 17 years, and Hispanic ethnicity. All the factors in the Florida model were also significant in the national model.

CONCLUSIONS. Lack of a personal health care provider is driven by larger community issues of health insurance, socioeconomic status, and ethnicity, including race, on a national level. To achieve the goal of a personal health care provider for children, a multifaceted approach needs to be considered. Knowing which children are without a personal health care provider provides valuable information for state policy-makers, program planners, and evaluators.

Key Words: children • primary health care

Abbreviations: AAP—American Academy of Pediatrics • NSCH—National Survey of Children's Health • OR—odds ratio • CI—confidence interval

Accepted Sep 15, 2006.