Barriers to the Use of Preventive Health Care Services for Children

THIS ARTICLE DESCRIBES findings from interviews of parents targeted for outreach efforts that encouraged them to use Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program. Begun in the 1970s, the EPSDT Program held out the promise of ensuring that needy children would...

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Bibliographic Details
Published in:Public health reports (1974) 1996-01, Vol.111 (1), p.71-77
Main Authors: Roberta Riportella-Muller, Maija L. Selby-Harrington, Lenora A. Richardson, Patricia L. N. Donat, Kathryn J. Luchok, Quade, Dana
Format: Article
Language:English
Subjects:
Biological and medical sciences
Child
Child care
Child health
Child health services
Child Health Services - standards
Child Health Services - utilization
Child, Preschool
Children
Demography
General aspects
Health care services
Health conditions
Health Services Accessibility
Humans
Immunization
Infant
Infant, Newborn
Medicaid
Medicaid program
Medical sciences
Medicine, Preventive
Motivation
North Carolina
Nurses
Parents
Planification. Prevention (methods). Intervention. Evaluation
Preventive Health Services - standards
Preventive Health Services - utilization
Public health
Public health. Hygiene
Public health. Hygiene-occupational medicine
Sampling Studies
Scientific Contributions
Transportation
United States
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Summary:THIS ARTICLE DESCRIBES findings from interviews of parents targeted for outreach efforts that encouraged them to use Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program. Begun in the 1970s, the EPSDT Program held out the promise of ensuring that needy children would receive comprehensive preventive health care. With only one-third of eligible children in the United States receiving EPSDT checkups, the program has yet to fulfill its promise. This study sought to understand parents' perceptions of barriers to using EPSDT by interviewing (a) 110 parents who did not schedule EPSDT checkups for their children after being exposed to outreach efforts and (b) 30 parents who did. Although the EPSDT Program is designed to provide health care at no charge and to provide assistance with appointment scheduling and transportation, these low-income parents identified significant barriers to care. Reasons for not using EPSDT services included (a) competing family or personal issues and priorities; (b) perceived or actual barriers in the health care system; and (c) issues related directly to problems with the outreach efforts. Parents who successfully negotiated these barriers and received EPSDT services encountered additional barriers, for example, scheduling and transportation difficulties, long waiting room times, or care that they perceived to be either unresponsive to their medical needs or interpersonally disrespectful. The implications for future outreach efforts and improving access to preventive health care services are discussed.
ISSN:0033-3549
1468-2877