Sources of health care and health needs among children in kinship care

S. Feigelman, S. Zuravin, H. Dubowitz, D. Harrington, R. H. Starr Jr and V. Tepper
Department of Pediatrics, University of Maryland at Baltimore, USA.

OBJECTIVES: To determine the characteristics of children in kinship care and their caregivers who have access to health care (a single source of health care or a single provider), and to determine the relation between indicators of access and health needs. DESIGN: Cross-sectional. SETTING: A large eastern city. SUBJECTS: Two hundred ten children selected from households with children in kinship care in April 1989. METHODS: Data were obtained from medical records, access and demographic questionnaires, and a medical and psychologic evaluation. RESULTS: A single facility for health care was reported by 93% of the sample; two thirds of those identified one health care provider. One source of care or one provider was associated with variables such as young age at placement and medical assistance insurance. Children who did not have a single source of care were more likely to have unmet health needs (87% vs 61%, P < .05), especially unmet mental health needs (60% vs 31%, P < .05). CONCLUSIONS: Children in kinship care had good access to health care, but the level of unmet health needs was high. Children who did not have a single source of health care were more likely to have unmet health needs, especially unmet mental health needs. These findings have implications for future health care planning for children in out-of-home care.