Children in the U.S. who have health insurance are seeing their pediatricians a lot less often than they did a decade ago, according to a new analysis. But both the reasons for this and whether it’s a good or a bad thing are less clear.
University of Pittsburgh researchers examined a large database of insurance claims for children 17 and younger covered under a major commercial insurance plan in all 50 states. Over a 10-year period, primary care visits to pediatricians for any reason declined by 14%. While preventive care, or “well child,” visits increased by nearly 10%, the data showed a much larger 24% decrease in problem-based visits for illnesses and injuries. The one exception was visits for psychiatric and behavioral health issues, which increased by more than 40%.
“There’s something big going on here that we need to be paying attention to,” said lead author Kristin Ray, M.D., M.S., a pediatrician and assistant professor of pediatrics in Pitt’s School of Medicine. “The question is: Why? We don’t have the definitive answer, but our data give us some clues.”
Ray said one possible explanation is that children are getting problem-based care elsewhere, from sources like urgent care centers, retail clinics and telemedicine providers, which increased during the study period – but that increase accounts for only about half of the decline in visits to pediatricians. Another more concerning reason could be higher out-of-pocket costs for problem visits, which increased by an average of 42% during the study period, she added.