Uncertain health insurance coverage and unmet children's health care needs

Jennifer Devoe, Moira Ray, Lisa Krois, Matthew J. Carlson

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background and Objectives: The State Children's Health Insurance Program (SCHIP) has improved insurance coverage rates. However, children's enrollment status in SCHIP frequently changes, which can leave families with uncertainty about their children's coverage status. We examined whether insurance uncertainty was associated with unmet health care needs. Methods: We compared self-reported survey data from 2,681 low-income Oregon families to state administrative data and identified children with uncertain coverage. We conducted cross-sectional multivariate analyses using a series of logistic regression models to test the association between uncertain coverage and unmet health care needs. Results: The health insurance status for 13.2% of children was uncertain. After adjustments, children in this uncertain "gray zone" had higher odds of reporting unmet medical (odds ratio [OR] =1.73; 95% confidence interval [CI]=1.07, 2.79), dental (OR=2.41; 95% CI=1.63, 3.56), prescription (OR=1.64, 95% CI=1.08, 2,48), and counseling needs (OR=3.52; 95% CI=1.56, 7.98), when compared with publicly insured children whose parents were certain about their enrollment status. Conclusions: Uncertain children's insurance coverage was associated with higher rates of unmet health care needs. Clinicians and educators can play a role in keeping patients out of insurance gray zones by (1) developing practice interventions to assist families in confirming enrollment and maintaining coverage and (2) advocating for policy changes that minimize insurance enrollment and retention barriers.

Original languageEnglish (US)
Pages (from-to)121-132
Number of pages12
JournalFamily Medicine
Volume42
Issue number2
StatePublished - Feb 2010

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Insurance Coverage
Health Insurance
Child Care
Delivery of Health Care
Insurance
Odds Ratio
Confidence Intervals
Uncertainty
Family Leave
Logistic Models
Social Adjustment
Child Health
Health Status
Prescriptions
Counseling
Tooth
Multivariate Analysis
Cross-Sectional Studies
Parents

ASJC Scopus subject areas

  • Family Practice

Cite this

Devoe, J., Ray, M., Krois, L., & Carlson, M. J. (2010). Uncertain health insurance coverage and unmet children's health care needs. Family Medicine, 42(2), 121-132.

Uncertain health insurance coverage and unmet children's health care needs. / Devoe, Jennifer; Ray, Moira; Krois, Lisa; Carlson, Matthew J.

In: Family Medicine, Vol. 42, No. 2, 02.2010, p. 121-132.

Research output: Contribution to journalArticle

Devoe, J, Ray, M, Krois, L & Carlson, MJ 2010, 'Uncertain health insurance coverage and unmet children's health care needs', Family Medicine, vol. 42, no. 2, pp. 121-132.
Devoe, Jennifer ; Ray, Moira ; Krois, Lisa ; Carlson, Matthew J. / Uncertain health insurance coverage and unmet children's health care needs. In: Family Medicine. 2010 ; Vol. 42, No. 2. pp. 121-132.
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