Lack of a regular source of care among children using a public hospital emergency department

Objectives: This study examined risk factors for not having a regular sourc e of care among children presenting to an urban public hospital for nonappo intment care. Lack of a regular source of care is associated with decreased use of appropriate health care services and preventive care among children . Methods: A cross-sectional survey was conducted for all children less than 16 years of age attending an emergency department at an urban public hospit al over a consecutive 7-day period. Univariate and multivariate logistic re gression analyses were conducted. Results: In 791 interviews available for analysis, 52% of preschool childre n and 66% of school-aged children did not have a regular source of care. Ch ildren without a regular source of care were more likely to present for non urgent conditions (P < 0.0005). In multivariate analysis, older age of the child (OR = 1.6, 95% CI 1.13-2.25), lack of insurance (OR = 1.47, 95% CI 1. 03-2.11), and lack of personal vehicle (OR = 1.44, 95% CI 1.05-1.97) were a ssociated with not having a regular source of care. Conclusions: The majority of children using an urban emergency department w ere without a regular source of care. In this population, no single factor identified children without a regular source of care, but increased age and lack of insurance were associated with it. Addressing this situation will require a multifaceted approach that includes, but is not limited to, decre asing financial barriers.