Children's Receipt of Health Care Services and Family Health Insurance Patterns

Jennifer E. DeVoe · Carrie J. Tillotson · L. S. Wallace

69 citations0/0 files storedThe Annals of Family Medicine

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Healthcare Policy and Management Healthcare Systems and Reforms Child and Adolescent Health

Abstract

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.

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References

2003Sicker and Poorer—The Consequences of Being Uninsured: A Review of the Research on the Relationship between Health Insurance, Medical Care Use, Health, Work, and Income 1997The Medical Expenditure Panel Survey: a national health information resource.2005Children in the United States with Discontinuous Health Insurance Coverage 2007Insurance + Access != Health Care: Typology of Barriers to Health Care Access for Low-Income Families 1995The Effect of Gaps in Health Insurance on Continuity of a Regular Source of Care Among Preschool-aged Children in the United States 2003Expanding Public Health Insurance to Parents: Effects on Children's Coverage under Medicaid 1998Impact of a Medicaid Primary Care Provider and Preventive Care on Pediatric Hospitalization 1999Changes in access to care, 1977-1996: the role of health insurance.

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