204829 Usual source of care or health insurance coverage: Which matter most in men's receipt of reproductive and general health care services?

Monday, November 9, 2009

Marina J. Chabot, MSc , Bixby Center for Global Reproductive Health, University of California, San Francisco, Sacramento, CA
Carrie Lewis, MPH , Bixby Center for Global Reproductive Health, University of California, San Francisco, Sacramento, CA
Heike Thiel de Bocanegra, PhD, MPH , Bixby Center for Global Reproductive Health, University of California, San Francisco, Sacramento, CA
Access to health care is one of Healthy People 2010's ten leading health indicators. Using the 2002 National Survey of Family Growth, survey of men ages 15-44 (n=4928), we examined whether having a usual source of care is more important than having health care insurance coverage in receiving services such as contraceptive advice/method, STD testing/treatment, HIV advice, testicular, and physical exams. We combined two survey items, usual source of care and health insurance status, to form one variable consisting of: (1) having both health insurance and usual source of care (HI/US); (2) having health insurance but no usual source of care (HI/NUS); (3) not having health insurance but with usual source of care (NHI/US); (4) having neither health insurance nor usual source of care (NHI/NUS). After controlling for sociodemographic factors, results of multivariate logistic regression analyses suggest a consistent pattern, with the odds of receiving general and reproductive health service highest among the HI/US group and lowest for the HI/NUS group when compared with NHI/NUS, the reference group. For example, men with both HI/US were X times, men with NHI/US 2.9 times, and men with HI/NUS only 1.7 times more likely to have received contraceptive advice/method compared to men with neither health insurance nor usual source of care. Usual source of care appears to provide additional advantages toward receipt of health services. Efforts to reform the nation's health care system should favor options that provide both universal health insurance coverage and the establishment of a usual source of care.

Learning Objectives:
1) Identify the reproductive and general health care services that men aged 15-44 were receiving in the United States. 2) Describe the characteristics of men who belong in the four groups identified as having both health insurance and a usual source of care, having health insurance only or a usual source of care only, and having neither. 3) Assess the importance for men in having both health care insurance coverage and a usual source of care in receiving reproductive and general health care services.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I initiated the concept, data analysis, and write-up of this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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