Predictors of delayed or forgone health care for families with children: A nationally representative, population-based study

We sought to determine how health care related financial burden, having a child with an activity limitation and other factors are related to delayed or forgone care for families with children, using a nationally representative population-based sample. We examined data on 6,273 families from five full panels of the 2001-2006 Medical Expenditure Panel Survey. Financial burden was defined as the sum of health insurance premiums and out-of-pocket health service expenditures during the first year of the survey. Excessive financial burden was defined as burden exceeding 10% of adjusted family income. Delayed or forgone care was defined as self-report of delayed or forgone medical care or prescription medications for either parent or the reference child (during the 2nd year of the survey). Experiencing excessive financial burden (OR 1.42, 95% CI: 1.12 - 1.80), having a child with an ongoing activity limitation (OR 2.11, 95% CI: 1.51 2.96), and partial insurance for the reference parent (OR 1.97, 95% CI: 1.32 2.94) were all significantly associated with increased odds of experiencing delayed or forgone care, adjusting for relevant covariates. Having concordant insurance between the reference parent and child was significantly associated with reduced odds of experiencing delayed or forgone care, adjusting for covariates (OR 0.60, 95% CI: 0.41 0.87). Children and their families are delaying or forgoing needed care due to health care related financial burden. Reducing financial burden and improving the concordance of insurance between parents and children may reduce the frequency of delayed or forgone care among families.