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.