Statistical Brief #12 

Children's Access to Necessary Health Care, Fall 2001 

by Frances M. Chevarley, Ph.D. 

Introduction 

The quality of the health care received by children in America is an issue of public policy 

concern for several reasons. First, the quality of the health care delivery system is 

critical for maintaining the health and well-being of children. In addition, all children 

may not be receiving care equally. Following these subgroups of children over time can 

provide information about whether greater equity has been achieved or whether serious 

gaps remain. In 2001, a new child supplement was added to the Medical Expenditure 

Survey (MEPS) that contained a variety of health status and quality of care measures of 

children. This MEPS Statistical Brief presents preliminary analyses of what is reported 

about the quality of children’s medical care based on the 2001 MEPS child supplement. 

The health care quality measures in the 2001 child supplement had previously been asked 

in a parent-administered questionnaire (PAQ) as part of the 2000 MEPS. The 2000 

parent-administered questionnaire and the 2001 child supplement were added to the 

Medical Expenditure Panel Survey (MEPS) to enhance the ability of MEPS to address 

quality of care issues. The health care quality measures for this study were taken from the 

health plan version of CAHPS®, an AHRQ sponsored family of survey instruments 

designed to measure quality of care from the consumer’s perspective. The Child 

Supplement was administered in late 2001. All of the questions refer to events 

experienced in the last 12 months. Only differences that are statistically significant at the 

0.05 level are discussed in the text.

Access to Care: Problems receiving needed care 

Overall, 75.8 percent of children under age 18 (53.8 million children in the U.S. civilian 

noninstitutionalized population) were reported to have one or more visits to a doctor’s 

office or clinic in the last 12 months (figure 1). Children ages 5 and under were more 

likely to have one or more visits reported than older children (85.5 % for ages 5 and 

under, 71.0 % for ages 6-11, 70.6 % for ages 12-17). Among those children receiving 

care, 91.9 percent were reported as not having problems receiving care their parents or 

doctors believed necessary (figure 2). Hispanic children were more likely than black 

children or white children to have a problem receiving needed care reported (percent 

reporting no problem: 88.4 % of Hispanic children, 91.7 % of black children, 92.7 % of 

white children). This differential pattern of Hispanic children being more likely than 

white children to have a problem receiving needed care reported was consistent for young 

children (ages 5 and under), as well as for older children (ages 12-17). In addition, 

uninsured children or those with public-only coverage were more likely to have a 

problem receiving needed care reported than were children with private coverage 

(percent reporting no problem: 89.1 % for uninsured children; 89.5 % for children with 

public-only coverage, 93.2 % for privately insured children) (figure 3). 
About MEPS and CAHPS® 

This Statistical Brief summarizes an access and quality of care measure pertaining to the 

health care received by noninstitutionalized children of the United States. The Medical 

Expenditure Panel Survey (MEPS) collects nationally representative data on health care 

use, expenditures, sources of payment, insurance coverage and the quality of care for the 

U.S. civilian noninstitutionalized population. MEPS is sponsored by the Agency for 

Healthcare Research and Quality (AHRQ). The health care quality measures used for this 

study were taken from the health plan version of CAHPS®, an AHRQ sponsored family 

of survey instruments designed to measure quality of care from the consumer’s 

perspective. A response rate of 68 percent was achieved for the 2001 MEPS child 

supplement. There were 9,000 respondents to the 2001 child supplement. Specific item 

nonresponse rates varied from 0.0 to 0.7 percent for the study questions. All insurance 

coverage estimates are based on health insurance status for the first part of 2001. More 

information about MEPS can be obtained through the MEPS website at 

www.meps.ahrq.gov. More information about CAHPS® can be obtained through the

CAHPS® website (www.cahps.ahrq.gov) or on the AHRQ website (www.ahrq.gov).