Etzel, Chilton, Watson & Gorski, 2012). For each child, there must be consistent primary care preventative services for addressing important pediatric conditions, milestones, and illnesses. In making
evidence-based recommendations, for children and adolescents, and factors that influence the use of these recommendations and other guidelines by clinicians will create a positive outcome and benefit the children tremendously (Burns, Dunn, Brady, Starr, Blosser, 2016). In designing the Affordable Care Act (ACA), special attention was given to be sure that children were well covered by our system of public and private programs (Kuo, Etzel, Chilton, Watson & Gorski, 2012). Yet, over 20 million children still have access barriers to essential health care services. Some of the reasons for this impaired access is that 3.3 million children do not have health insurance at all (Kuo, Etzel, Chilton, Watson & Gorski, 2012). Also, millions of children are counted as insured, but have frequent gaps in coverage for many different reasons related to fragmented nature of healthcare financing post ACA. Additionally, high patient cost sharing and high prices frequently impair access to care. Non-financial barriers are often seen in the geographic location and the lack of ease of access to information on the children’s health. Geographic barriers include problems with transportation, such as lack of vehicle access, poor public transit options, and federal-designed HPSA where the number of health professionals in a given geographical area are insufficient for the needs of healthcare in that specific population (Kuo, Etzel, Chilton, Watson & Gorski, 2012). It is estimated that over 14 million children live in these HSPA. Informational barriers include parents’ health illiteracy, a dauntingly complex language used in information about coverage eligibility and accessing care, and parents’ limitations to English proficiency (Kuo, Etzel, Chilton, Watson & Gorski, 2012).
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