TY - JOUR
T1 - Children's receipt of health care services and family health insurance patterns
AU - DeVoe, Jennifer E.
AU - Tillotson, Carrie J.
AU - Wallace, Lorraine S.
N1 - Funding Information:
Funding support: Dr DeVoe's time was partially supported by grant No. 1 K08 HS16181 from the Agency for Healthcare Research and Quality (AHRQ) and by the Oregon Health and Science University Department of Family Medicine. Ms Tillotson was supported by the Oregon Clinical and Translational Research Institute (OCTRI), grant No. UL1 RR024140 01 from the National Center for Research Resources, and NIH Roadmap for Medical Research .
PY - 2009
Y1 - 2009
N2 - PURPOSE: Insured children in the United States have better access to health care services; less is known about how parental coverage affects children's access to care. We examined the association between parent-child health insurance coverage patterns and children's access to health care and preventive counseling services. METHODS: We conducted secondary analyses of nationally representative, cross-sectional, pooled 2002-2006 data from children (n = 43,509), aged 2 to 17 years, in households responding to the Medical Expenditure Panel Survey (MEPS). We assessed 9 outcome measures pertaining to children's unmet health care and preventive counseling needs. RESULTS: Cross-sectionally, among US children (aged 2 to 17 years) living with at least 1 parent, 73.6% were insured with insured parents, 8.0% were uninsured with uninsured parents, and the remaining 18.4% had discordant family insurance coverage patterns. In multivariable analyses, insured children with uninsured parents had higher odds of an insurance coverage gap (odds ratio [OR] = 2.45; 95% confidence interval [CI], 2.02-2.97), no usual source of care (OR = 1.31; 95% CI, 1.10-1.56), unmet health care needs (OR = 1.11; 95% CI, 1.01-1.22), and having never received at least 1 preventive counseling service (OR = 1.20; 95% CI, 1.04-1.39) when compared with insured children with insured parents. Insured children with mixed parental insurance coverage had similar vulnerabilities. CONCLUSIONS: Uninsured children had the highest rates of unmet needs overall, with fewer differences based on parental insurance status. For insured children, having uninsured parents was associated with higher odds of going without necessary services when compared with having insured parents.
AB - PURPOSE: Insured children in the United States have better access to health care services; less is known about how parental coverage affects children's access to care. We examined the association between parent-child health insurance coverage patterns and children's access to health care and preventive counseling services. METHODS: We conducted secondary analyses of nationally representative, cross-sectional, pooled 2002-2006 data from children (n = 43,509), aged 2 to 17 years, in households responding to the Medical Expenditure Panel Survey (MEPS). We assessed 9 outcome measures pertaining to children's unmet health care and preventive counseling needs. RESULTS: Cross-sectionally, among US children (aged 2 to 17 years) living with at least 1 parent, 73.6% were insured with insured parents, 8.0% were uninsured with uninsured parents, and the remaining 18.4% had discordant family insurance coverage patterns. In multivariable analyses, insured children with uninsured parents had higher odds of an insurance coverage gap (odds ratio [OR] = 2.45; 95% confidence interval [CI], 2.02-2.97), no usual source of care (OR = 1.31; 95% CI, 1.10-1.56), unmet health care needs (OR = 1.11; 95% CI, 1.01-1.22), and having never received at least 1 preventive counseling service (OR = 1.20; 95% CI, 1.04-1.39) when compared with insured children with insured parents. Insured children with mixed parental insurance coverage had similar vulnerabilities. CONCLUSIONS: Uninsured children had the highest rates of unmet needs overall, with fewer differences based on parental insurance status. For insured children, having uninsured parents was associated with higher odds of going without necessary services when compared with having insured parents.
KW - Access to health care
KW - Health insurance
KW - Health policy
KW - Primary health care
KW - SCHIP
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U2 - 10.1370/afm.1040
DO - 10.1370/afm.1040
M3 - Article
C2 - 19752468
AN - SCOPUS:70349185446
SN - 1544-1709
VL - 7
SP - 406
EP - 413
JO - Annals of family medicine
JF - Annals of family medicine
IS - 5
ER -