TY - JOUR
T1 - Comparing type of health insurance among low-income children
T2 - A mixed-methods study from Oregon
AU - Devoe, Jennifer E.
AU - Wallace, Lorraine
AU - Selph, Shelley
AU - Westfall, Nicholas
AU - Crocker, Stephanie
N1 - Funding Information:
This project received direct support from grant numbers K08 HS16181 and R01 HS018569 from the Agency for Healthcare Research and Quality (AHRQ) and the Oregon Health and Science University Department of Family Medicine. We also wish to thank our colleagues in the Oregon Office for Health Policy and Research and the Division of Medical Assistance Programs. We are also extremely grateful to the parents who shared their time and insights with us.
PY - 2011/11
Y1 - 2011/11
N2 - We employed a mixed-methods study of primary data from a statewide household survey and in-person interviews with parents to examine-quantitatively and qualitatively-whether low-income children experienced differences between public and private insurance coverage types. We carried out 24 in-depth interviews with a subsample of respondents to Oregon's 2005 Children's Access to Healthcare Study (CAHS), analyzed using a standard iterative process and immersion/crystallization cycles. Qualitative findings guided quantitative analyses of CAHS data that assessed associations between insurance type and parental-reported unmet children's health care needs. Interviewees uniformly reported that stable health insurance was important, but there was no consensus regarding which type was superior. Quantitatively, there were only a few significant differences. Cross-sectionally, compared with private coverage, public coverage was associated with higher odds of unmet specialty care needs (odds ratio [OR] 3.54; 95% confidence interval [CI] 1.52-8.24). Comparing full-year coverage patterns, those with public coverage had lower odds of unmet prescription needs (OR 0.60, 95% CI 0.36-0.99) and unmet mental health counseling needs (OR 0.24, 95% CI 0.10-0.63), compared with privately covered children. Low-income Oregon parents reported few differences in their child's experience with private versus public coverage.
AB - We employed a mixed-methods study of primary data from a statewide household survey and in-person interviews with parents to examine-quantitatively and qualitatively-whether low-income children experienced differences between public and private insurance coverage types. We carried out 24 in-depth interviews with a subsample of respondents to Oregon's 2005 Children's Access to Healthcare Study (CAHS), analyzed using a standard iterative process and immersion/crystallization cycles. Qualitative findings guided quantitative analyses of CAHS data that assessed associations between insurance type and parental-reported unmet children's health care needs. Interviewees uniformly reported that stable health insurance was important, but there was no consensus regarding which type was superior. Quantitatively, there were only a few significant differences. Cross-sectionally, compared with private coverage, public coverage was associated with higher odds of unmet specialty care needs (odds ratio [OR] 3.54; 95% confidence interval [CI] 1.52-8.24). Comparing full-year coverage patterns, those with public coverage had lower odds of unmet prescription needs (OR 0.60, 95% CI 0.36-0.99) and unmet mental health counseling needs (OR 0.24, 95% CI 0.10-0.63), compared with privately covered children. Low-income Oregon parents reported few differences in their child's experience with private versus public coverage.
KW - CHIP
KW - Child access to care
KW - Child health insurance
KW - Health care disparities
KW - Health policy
KW - Health services research
KW - Medicaid
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U2 - 10.1007/s10995-010-0706-4
DO - 10.1007/s10995-010-0706-4
M3 - Article
C2 - 21052802
AN - SCOPUS:81255184762
SN - 1092-7875
VL - 15
SP - 1238
EP - 1248
JO - Maternal and child health journal
JF - Maternal and child health journal
IS - 8
ER -