Children’s Health Insurance Status and Emergency Department Utilization in the United States

Luo, Xuemei; Liu, Gordon; Frush, Karen; Hey, Lloyd A.

doi:10.1542/peds.112.2.314

Cited by 73 publications

(55 citation statements)

References 21 publications

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“…The insured had slightly more follow up clinic visits, more unscheduled clinic visits and twice more emergency room visits compared to their counterpart, the uninsured. This findings were similar to that of [16] Tanimola et al who reported 144% increase in the utilization of health service at university of Ilorin teaching hospital staff clinic and that of [8] reported increased likelihood of insured children visiting emergency room more than the uninsured children. The preponderance of emergency room visits among the insured may be due to absence of the deleterious effect of user fees on affordability of health services and drugs [5].…”

Section: Discussionsupporting

confidence: 90%

“…In general, it was reported in the available literature that health insurance coverage is associated with increase health resources utilization [8]. In this study, health services utilization of insured children with SCD was found to be significantly higher than those children without health insurance cover.…”

Section: Discussionmentioning

confidence: 49%

“…In Nigeria Tanimola A et al [16] reported that NHIS led to 144% increase in the utilization of health service at staff clinic of the University Teaching Hospital. A Study from North Carolina, USA reported that publicly insured children were more likely to have emergency department visit than uninsured children [8]. Conversely, uninsured persons more often forgo or delay medical services including preventive care compared with person who have health insurance [9].…”

Section: Health Services Utilization Health Insurance and Children Wmentioning

confidence: 99%

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Health Services Utilization and Health Status of Insured versus Uninsured Nigerian Children with Sickle Cell Disease

Salihu¹,

Umar²

2016

Health

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Introduction: Nigeria accounts for 150,000 infants born with the Sickle Cell Disease (SCD) every year. Children with SCD are affected by the deleterious effect of user fees which reduces affordability and utilization of health services. Evidences supported that institutionalized health insurance increases intensity of utilization. Methodology: The study was conducted at AKTH, Kano, and north-western, Nigeria. The study was retrospective comparative cross-sectional study. 100 patients were enrolled, 50 for each arm. Paediatric SCD clinic outpatients' records and a specialty designed form containing the variables of interest were used. Data were analysed using Minitab 16. Proportions, percentages, tables, charts and chi squared test were used to compare the two groups. Result: The study found no association between the two groups in the likelihood of being insured based on age (χ 2 = 1.478), gender (χ 2 = 0.224) and dwellings (χ 2 = 0.062). On health services utilization and insurance status, the study revealed that follow up clinic visits, unscheduled clinic visits and emergency room visits were more likely among the insured group compared to the uninsured group. While the health status and insurance status of the two groups over 12 months period showed a significant association with the insured more likely to have improved health status compared to uninsured (χ 2 = 28.019, p = 0.0001). Similarly, health status and health services utilization were significantly associated with insurance status (χ 2 = 12.191, p = 0.002). Conclusion: The insurance status of children with SCD is associated with their health services utilization and health status. However, age, gender and dwellings were not associated with insurance status of children with SCD. Therefore, when expanding insurance coverage (NHIS) among children with SCD considerations have to be given to increase health services utilization and resultant improvement in health status as these have the potential of reducing morbidity and mortality among children with SCD.A. S. Salihu, A. S. Umar 972

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 49%

Section: Health Services Utilization Health Insurance and Children Wmentioning

confidence: 99%

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Health Services Utilization and Health Status of Insured versus Uninsured Nigerian Children with Sickle Cell Disease

Salihu¹,

Umar²

2016

Health

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“…30 Despite the much higher cost of ED visits, poor children are three times as likely as other children to use EDs for nonurgent care. 31 EDs, however, are neither intended nor prepared to deliver the preventive care that these children lack. Thus, while EDs provide an important safety net for vulnerable populations, they do so inefficiently.…”

Section: Voltage Drop 3: Access To Covered Services and Providersmentioning

confidence: 99%

Access And Quality In Child Health Services: Voltage Drops

Schuster

2004

Health Affairs

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Children require a health care system that promotes healthy development for all children while reaching out to the neediest. Barriers to care have been described as "voltage drops"-resistance points at which patients drop from the system like voltage from an electrical current. We examine the size and nature of these drops, ranging from insurance access to service quality, with respect to children. We find critical policy needs (such as expanded insurance opportunities, increased care coordination, and improved quality measurement) at all system levels. Comprehensive access to insurance and services does not guarantee that children will receive high-quality (safe and effective) care. C h i l d h o o d i s a u n i q u e p e r i o d of rapid growth and development char-acterized by dependency, vulnerability, and, for a disproportionate number of children, poverty. The U.S. health care system, best suited to acute care for adults, struggles to accommodate vulnerable populations (such as the elderly or mentally ill). Children require a protective, preventive system-one that helps families anticipate upcoming needs, monitors problems as they arise, and coordinates services. Developing such a system is a critical health policy frontier.It is essential to understand where the current system succeeds and fails for children. John Eisenberg and Elaine Power adopted the term "voltage drops." Just as an electrical system loses voltage when current passes through resistance, the health care system loses people as they confront barriers in seven areas: access to insurance coverage, enrollment in available insurance plans, access to covered services/providers, choice of plans/providers, consistent access to primary care, access to referral services, and delivery of high-quality care. 1 For children, evidence is scant regarding one drop, the impact of plan/provider choice. The other six drops, however, clearly have policy implications that are the focus of this paper. How large are these drops for children, and how might they be reduced?

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“…Os serviços de urgência do Sistema Único de Saúde (SUS) destinados às crianças gravemente enfermas são também freqüentados por crianças com doenças mais simples, e as famílias os utilizam como porta de entrada ao sistema 4,9,10 , provocando elevada procura pelos serviços e interferindo no atendimento aos pacientes agudos, que são obrigados a enfrentarem as filas, embora cada serviço apresente um sistema de priorização mais ou menos eficiente.…”

Section: Introductionunclassified

O trabalho dos pediatras em um serviço público de urgências: fatores intervenientes no atendimento

2007

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Children’s Health Insurance Status and Emergency Department Utilization in the United States

Cited by 73 publications

References 21 publications

Health Services Utilization and Health Status of Insured versus Uninsured Nigerian Children with Sickle Cell Disease

Health Services Utilization and Health Status of Insured versus Uninsured Nigerian Children with Sickle Cell Disease

Access And Quality In Child Health Services: Voltage Drops

O trabalho dos pediatras em um serviço público de urgências: fatores intervenientes no atendimento

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