Agency for Healthcare 

Medical Expenditure Panel Survey Research and Quality 

STATISTICAL BRIEF #78 

May 2005 

Children’s Usual Source of Care: 

United States, 2002 

Erwin Brown, Jr., BS 

Introduction 

One goal of a health care system is to provide effective, equitable, 

and cost-effective health services to the population. A measure of a 

health care system’s effectiveness is the degree to which the population served can identify a place where they can receive routine 

medical care. Previous findings have shown that not having a usual 

source of care is linked with race/ethnicity, health insurance status, 

and family income. This may be especially true for populations such 

as uninsured children. Uninsured children are less likely to have their 

medical care needs met. In addition, uninsured children are much 

less likely to get immunizations, medicine, and treatment for ordinary 

childhood conditions, such as sore throats, ear infections, and 

asthma, which have severe consequences if left untreated.* 

This Statistical Brief provides estimates of the proportion of children 

under 18 who lacked a usual source of care in 2002, by race/ 

ethnicity, age, income, and insurance coverage. Only differences 

that are statistically significant at the 0.05 level are discussed in the 

text. 

Findings 

In 2002, approximately 10.1 percent of the 72.7 million U.S. population of children younger than 18 was reported as having no usual 

source of care. This translates into about 7.3 million children not 

having a usual place to go for health care. 

White children (7.3 percent) were less likely than any other race/ 

ethnic group to lack a usual source of care. Hispanic children (18.1

percent) were more likely than children of any other race/ethnic 

group to lack a usual source of care. Likewise, other/multiple race 

children (12.3 percent) and black children (10.6 percent) were more 

likely than white children (7.3 percent) to lack a usual source of care. 

(figure 1) 

Highlights 

� More than 7 million 

American children under 

18 were reported to have 

no usual place to go for 

health care during 2002. 

� Children who were 

uninsured were more 

likely to lack a usual 

source of care than 

children with public only 

insurance. Similarly, 

children with public only 

insurance were more 

likely to lack a usual 

source of care than those 

with private only insurance. 

� Hispanic children were 

more likely to lack a usual 

source of medical care 

than children who were 

white, black, or other/ 

multiple race. 

� In 2002, lower income 

children were more likely 

than middle and high 

income children to lack a 

usual source of health 

care. 

* Children’s Health—Why Health Insurance Matters, Fact Sheet (#4055), May 2002. Kaiser Commission on Medicaid and the 

Uninsured, Kaiser Family Foundation, Washington, D.C. 
With respect to family income, lower income children were less likely than middle and high income 

children to have a usual source of medical care. While only 5.4 percent of high income and 8.2 percent of 

middle income children did not have a usual source of care, 14.9 percent of low income, 17.0 percent of 

near poor, and 15.0 percent of poor children did not have a usual source of care (figure 2). 

Uninsured children were more than five times (34.1 percent) as likely to lack a usual source of care as 

children with private only insurance (6.5 percent). Likewise, children who were uninsured were nearly 

three times as likely to lack a usual source of care as those with public only insurance (12.4 percent). 

(figure 3) 

Data Source 

The estimates in this Statistical Brief are based on data from the Household Component of the Medical 

Panel Expenditure Survey (MEPS-HC) for 2002. The usual source of care questions are contained in the 

Access to Care section of the survey. One household respondent reported information for all members of 

the household. 

Definitions 

Health insurance status 

Respondents were asked about health insurance coverage for themselves and all household 

members at each round of interviewing. Persons were classified according to whether they had 

private health insurance only, public coverage only, or were uninsured all year. 

– Private only: Persons having insurance at any time during the year that provided coverage for 

hospital and physician care from a nonpublic source. Coverage only by private single-service 

plan (e.g., coverage for dental or vision care only or coverage for accidents or specific 

diseases) was not defined as private health insurance. 

– Public only: Persons who were never covered by private insurance during the year but who 

were covered at any time by Medicaid, State and local medical assistance programs, and 

TRICARE (which covers retired members of the uniformed services and the spouses and 

children of active-duty military). 

– Uninsured: Persons with neither public nor private insurance coverage throughout the calendar 

year. 

Usual source of care 

This refers to a particular doctor’s office, clinic, health center, or other place where a person 

usually goes if he or she is sick or needs advice about personal health matters. 

Race/ethnicity 

This is coded hierarchically into the following codes: White single race, black single race, 

Hispanic or Latino, and other/multiple race. 

Poverty status 

Income is expressed in terms of poverty status, the ratio of the family’s income to the Federal 

poverty thresholds, which control for the size of the family and the age of the head of the family 

(see the 2002 U.S. Department of Health and Human Services Poverty Guidelines at http://aspe. 

hhs.gov/poverty/02poverty.htm for more details). In this Statistical Brief, the following classifications were used: 

– Poor: Persons in families at or below the poverty line. 

– Near poor: Persons in families over the poverty line through 125 percent of the poverty line. 

– Low income: Persons in families with income from 125 percent to less than 200 percent of the 

poverty line. 

– Middle income: Persons in families with income from 200 percent to less than 400 percent of 

the poverty line. 

– High income: Persons in families with income at or over 400 percent of the poverty line. 

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 
demographic, and economic characteristics for the civilian noninstitutionalized population. It is cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

References 

For a detailed description of the MEPS-HC survey design, sample design, and methods used to minimize 

sources on nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care, 

July 2003: 41(7) Supplement: III-5–III-12. 

Suggested Citation 

Brown, E., Jr. Children’s Usual Source of Care: United States, 2002. Statistical Brief #78. May 2005. 

Agency for Healthcare Research and Quality, Rockville, Md.

http://meps.ahrq.gov/mepsweb/data_files/publications/st78/stat78.pdf 
Figure 1. Percentage of children with no usual source 

7.3 

10.6 

18.1

12.3 

0 

10 

20 

30 

40 

50 

Other/multiple race Hispanic Black White 

Percent 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2002 

of care, by race/ethnicity, United States, 2002 

Figure 2. Percentage of children with no usual source 

5.4 

14.9 17.0 15.0 

0 

10 

20 

30 

40 

50 

Poor Near poor Low income High income 

Percent 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2002 

of care, by poverty status, United States, 2002 

8.2 

Middle income 
Figure 3. Percentage of children with no usual source 

of care, by insurance coverage, United States, 2002 

6.5 

12.4 

34.1 

0 

10 

20 

30 

40 

50 

Uninsured Public Only Private Only 

Percent 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2002