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Distance to Hospitals and Children's Access to Care: Is Being Closer Better, and for Whom?

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  • Janet Currie
  • Patricia Reagan

Abstract

Distance to hospital may affect the utilization of primary preventative care if children rely on hospitals for such routine care. We explore this question using matched data from the National Longitudinal Survey of Youth's Child-Mother file and the American Hospital Association's 1990 Hospital Survey. Our measure of preventative care is whether or not a child has received a regular checkup in the past year. We find that distance to hospital has significant effects on the utilization of preventative care among central-city black children. For these children, each additional mile from the hospital is associated with a 3 percent decline in the probability of having had a checkup (from a mean baseline of 74 percent). This effect can be compared to the 3 percent increase in the probability of having a checkup which is associated with having private health insurance coverage. The size of this effect is similar for both the privately insured and those with Medicaid coverage, suggesting that even black urban children with private health insurance may have difficulty obtaining access to preventative care. In contrast, we find little evidence of a negative distance effect among white or Hispanic central-city children, suburban children, or rural children.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 6836.

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Date of creation: Dec 1998
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Handle: RePEc:nbr:nberwo:6836

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  1. David M. Cutler & Louise Sheiner, 1998. "Managed Care and the Growth of Medical Expenditures," NBER Chapters, in: Frontiers in Health Policy Research, volume 1, pages 77-116 National Bureau of Economic Research, Inc.
  2. Janet Currie & Duncan Thomas, 1995. "Medical Care for Children: Public Insurance, Private Insurance, and Racial Differences in Utilization," Journal of Human Resources, University of Wisconsin Press, vol. 30(1), pages 135-162.
  3. David M. Cutler & Louise Sheiner, 1998. "Managed Care and the Growth of Medical Expenditures," Forum for Health Economics & Policy, De Gruyter, vol. 1, pages 4.
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Cited by:
  1. Anna Aizer & Adriana Lleras-Muney & Mark Stabile, 2004. "Access to Care, Provider Choice and Racial Disparities," NBER Working Papers 10445, National Bureau of Economic Research, Inc.
  2. John C. Ham, 1979. "Rationing and the Supply of Labor: An Econometric Approach," Working Papers 483, Princeton University, Department of Economics, Industrial Relations Section..
  3. Jeffrey R. Kling & B. Jeffrey Liebman, 2004. "Experimental Analysis of Neighborhood Effects on Youth," Working Papers 862, Princeton University, Department of Economics, Industrial Relations Section..
  4. Andrés Romeu & Ignacio Ortuño Ortín, 2003. "Altruism Vs. Exchange In Intergenerational Transfers: New Evidence From Children'S Health Care," Working Papers. Serie AD 2003-26, Instituto Valenciano de Investigaciones Económicas, S.A. (Ivie).
  5. Cutler, David M. & Mas, Nuria, 2003. "Comparing non-fatal health across countries: Is the US medical system better?," IESE Research Papers D/525, IESE Business School.

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