Disparities in access to preventive health care services among insured children in a cross sectional study

Abstract

Children with insurance have better access to care and health outcomes if their parents also have insurance. However, little is known about whether the type of parental insurance matters. This study attempts to determine whether the type of parental insurance affects the access to health care services of children.I used data from the 2009–2013 Medical Expenditure Panel Survey and estimated multivariate logistic regressions (N = 26,152). I estimated how family insurance coverage affects the probability that children have a usual source of care, well-child visits in the past year, unmet medical and prescription needs, less than 1 dental visit per year, and unmet dental needs.Children in families with mixed insurance (child publicly insured and parent privately insured) were less likely to have a well-child visit than children in privately insured families (odds ratio = 0.86, 95% confidence interval 0.76–0.98). When restricting the sample to publicly insured children, children with privately insured parents were less likely to have a well-child visit (odds ratio = 0.82, 95% confidence interval 0.73–0.92), less likely to have a usual source of care (odds ratio = 0.79, 95% confidence interval 0.67–0.94), and more likely to have unmet dental needs (odds ratio = 1.68, 95% confidence interval 1.10–2.58).Children in families with mixed insurance tend to fare poorly compared to children in publicly insured families. This may indicate that children in these families may be underinsured. Expanding parental eligibility for public insurance or subsidizing private insurance for children would potentially improve their access to preventive care.

Children’s health insurance coverage and adequacy from 2016 to 2018: Racial/ethnic disparities under the ACA

“…2,24,26 Our study validates the racial/ethnic disparities in children's health insurance enrollment and adequacy, which has been documented in previous research. 19,24,27 Our analyses indicate that white children and AAPI children are more likely to enroll in employer-based health insurance. Black children and AIAN children are mainly covered by Medicaid and other government aided health care programs.…”

Racial/Ethnic Differences in Health Insurance Adequacy and Consistency among Children: Evidence from the 2011/12 National Survey of Children's Health

“…It builds on previous research on this subject and adds to the understanding of the role of these characteristics within the context of race/ethnicity in influencing healthcare insurance coverage. 9 , 18 , 19 …”

Use of a Teledentistry Partnership Program to Reach a Rural Pediatric Population

“…Tooth decay is one of the most preventable childhood diseases, yet oral health care remains the most prevalent unmet health care need for children, especially low-income children (King 2016). Because of the lack of providers, rural areas have additional barriers to dental care when compared to other locations (Yu 2017).…”