Access to medical care for adolescents: Results from the 1997 CommonwealthFund Survey of the Health of Adolescent Girls

Purpose: This study examined the factors associated with access to care amo ng adolescents, including gender, insurance coverage, and having a regular source of health care. Methods: Analyses were done on the 1997 Commonwealth Fund Survey of the Hea lth of Adolescent Girls, a nationally representative sample of in-school ad olescents in 5th through 12th grade. Access to health care, missing needed care, and whether the adolescent had private time with their provider were assessed. Cochran-Mantel-Haenszel chi-square statistics were computed using SUDAAN. Results: Nearly a third of the 6748 adolescents surveyed had missed needed care. The most common reason for missing care was not wanting a parent to k now (35%). Girls were more likely than boys to miss care (29% vs. 24%). Mos t adolescents reported using a source of primary health care (92%); girls w ere more likely than boys to use a physician's office rather than another s ite (65% vs. 60%). Eleven percent of adolescents reported having no health insurance. Uninsured adolescents were more likely to have missed needed car e (40% vs. 23%). Conclusions: Certain groups of adolescents have less access to health care. Girls have more emotional barriers, such as not wanting parents to know ab out care, and embarrassment. Adolescents without health insurance are at hi gh risk for missing care because of financial strain. States, insurers, and advocates can influence policies around confidentiality and insurance cove rage to address these issues. (C) Society for Adolescent Medicine, 1999.