Effects of health insurance and usual source of care on men's use of sexual and reproductive health services

Objectives: We study the effects of having health insurance and a usual source of care (USC) on men's use of sexual and reproductive health services (SRHS).

Methods: We estimated a multinomial logistic regression model using data from the 2002 NSFG. The sample included 2,922 black, white, and Hispanic (>19 years) men who were sexually active with a female in the past year. We tested for an interaction between insurance status and USC, calculated predicted probabilities, and compared differences in service-use probabilities by insurance and USC.

Results: There was a significant interaction (P<.05) between health insurance and USC on service utilization. Insured men with a USC had the highest probabilities of receiving a physical exam and SRHS or physical exam alone, while uninsured men with no USC had the lowest. Regardless of insurance status, men with a USC were more likely than those without one (P<.001) to receive both a physical and SRHS. Insured men with a USC were more likely (P<.001) than insured men without a USC to receive both a physical and SRHS. There were no differences in service use patterns between insured men without a USC and uninsured men with a USC.

Conclusions: Having a USC reduces but does not eliminate insurance-related differences in access to preventive and SRH care. Uninsured men without a USC are at highest risk of poor health outcomes from to low use of preventive and SRH services. For the uninsured, having a USC can eliminate disparities in use of essential preventive care.