Ohio Study Shows That Insurance Coverage Is Critical For Children With Special Health Care Needs As They Transition To Adulthood

Goudie, Anthony; Carle, Adam C.

doi:10.1377/hlthaff.2011.0641

Cited by 22 publications

(14 citation statements)

References 23 publications

(17 reference statements)

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“…YSHCN with private medical insurance or private insurance and Medicaid were more likely to use dental care than uninsured youth (RR=1.15 and RR=1.21, respectively). Adequate medical insurance was the strongest predictor of dental utilization for YSHCN (RR=1.51), which is consistent with other studies on health transitions [10,37]. Although health insurance is not a sufficient condition for dental care use, our findings support policies that enable youth to maintain comprehensive coverage under a parent’s health plan until age 26 – a key feature of the U.S.…”

Section: Discussionsupporting

confidence: 90%

Medical Care Transition Planning and Dental Care Use for Youth with Special Health Care Needs During the Transition from Adolescence to Young Adulthood: A Preliminary Explanatory Model

Donald

2013

Matern Child Health J

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Objectives To test the hypotheses that youth with special health care needs (YSHCN) with a medical care transition plan are more likely to use dental care during the transition from adolescence to young adulthood and that different factors are associated with dental utilization for YSHCN with and YSHCN without functional limitations. Methods National Survey of CSHCN (2001) and Survey of Adult Transition and Health (2007) data were analyzed (N=1,746). The main predictor variable was having a medical care transition plan, defined as having discussed with a doctor how health care needs might change with age and having developed a transition plan. The outcome variable was dental care use in 2001 (adolescence) and 2007 (young adulthood). Multiple variable Poisson regression models with robust standard errors were used to estimate covariate-adjusted relative risks (RR). Results About 63% of YSHCN had a medical care transition plan and 73.5% utilized dental care. YSHCN with a medical care transition plan had a 9% greater relative risk (RR) of utilizing dental care than YSHCN without a medical care transition plan (RR:1.09; 95% CI:1.03–1.16). In the models stratified by functional limitation status, having a medical care transition plan was significantly associated with dental care use, but only for YSHCN without functional limitations (RR:1.11; 95% CI:1.04–1.18). Conclusions Having a medical care transition plan is significantly associated with dental care use, but only for YSHCN with no functional limitation. Dental care should be an integral part of the comprehensive health care transition planning process for all YSHCN.

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Section: Discussionsupporting

confidence: 90%

Medical Care Transition Planning and Dental Care Use for Youth with Special Health Care Needs During the Transition from Adolescence to Young Adulthood: A Preliminary Explanatory Model

Donald

2013

Matern Child Health J

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“… 39 Young adults with special health care needs who are uninsured have been shown to delay or forgo care and to have problems getting care. 40 In our study, 4 in 10 non-ambulatory males aged 24-30 reported changing health insurance coverage in the past 12 months as compared to none of the non-ambulatory males aged 16-18 years. The reasons for the high proportion of non-ambulatory males aged 24–30 years who changed their health insurance coverage are unknown; possible explanations include men changing from their parents’ insurance to their own insurance, or qualifying for Medicare or Medicaid.…”

Section: Discussionmentioning

confidence: 49%

Health Care Transition Experiences of Males with Childhood-onset Duchenne and Becker Muscular Dystrophy: Findings from the Muscular Dystrophy Surveillance Tracking and Research Network (MD STARnet) Health Care Transitions and Other Life Experiences Survey

et al. 2018

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Introduction:As the proportion of males with Duchenne muscular dystrophy (DMD) surviving into adulthood increases, more information is needed regarding their health care transition planning, an essential process for adolescents and young adults with DMD. The objective of this study was to describe the health care transition experiences of a population of males living with Duchenne or Becker muscular dystrophy (DBMD).Methods:The eligible participants, identified through the Muscular Dystrophy Surveillance Tracking and Research Network (MD STARnet) surveillance project, were 16–31 years old and lived in Arizona, Colorado, Georgia, Iowa, or western New York (n=258). The MD STARnet Health Care Transitions and Other Life Experiences Survey was conducted in 2013 and administered online or in a telephone interview. Sixty-five males (25%) completed the survey. Among non-ambulatory males, response differences were compared by age group. Statistical comparisons were conducted using Fisher’s exact test, or when appropriate, the Chisquare test.Results:Twenty-one percent of non-ambulatory males aged 16–18 years, 28% of non-ambulatory males aged 19–23 years, 25% of non-ambulatory males aged 24–30 years, and 18 ambulatory males had a written transition plan. Nineteen percent of non-ambulatory males aged 24–30 years had delayed or gone without needed health care in the past 12 months. Among non-ambulatory males aged 24–30 years, 75% had cardiology providers and 69% had pulmonology providers involved in their care in the past 12 months. Twentyeight percent of non-ambulatory males aged 19–23 years and 25% of non-ambulatory males aged 24–30 years reported that they did not receive health care or other services at least once because they were unable to leave their home. Non-ambulatory males aged 16–18 years (29%) were less likely to have ever discussed how to obtain or keep health insurance as they get older compared to non-ambulatory males aged 24-30 years (69%) (p <0.01).Discussion:This study identified potential barriers to the successful health care transition of males with DBMD. The results of this study may indicate a lack of targeted informational resources and education focused on supporting the transition of young men with DBMD as they age from adolescence into adulthood within the healthcare system. Future studies could determine the reasons for the potential barriers to health care and identify the optimal transition programs for males with DBMD. There are a few online resources on transition available to adolescents and young adults with special health care needs.

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“…These outcomes are often the result of preventable lapses in adherence, 4 follow-up, 5 and insurance coverage. 6 Preventing adverse outcomes during transition requires support, especially for youth with special health care needs. In 2011, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians jointly developed a report on transition that includes a set of specific clinical activities recommended for all youth beginning at age 12 7 ; yet, national data reveal that most youth do not receive needed transition services.…”

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confidence: 99%

Measuring the “Triple Aim” in Transition Care: A Systematic Review

et al. 2014

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BACKGROUND AND OBJECTIVES: Without adequate support, adolescents transitioning from the pediatric to the adult health care system are at increased risk for poor health outcomes. Numerous interventions attempt to improve this transition, yet few comprehensively evaluate efficacy. To advance evaluation methods and ultimately the quality of transition services, it is necessary to understand the current state of health care transition measurement. This study examines and categorizes transition measures by using the “Triple Aim” framework of experience of care, population health, and cost of care. METHODS: Ovid Medline and the Cumulative Index to Nursing and Allied Health Literature were searched for articles published between 1995 and 2013. Two reviewers independently screened studies and included those that evaluated the impact of a health care transition intervention. Measures were subsequently classified according to population health, experience of care, and costs of care. RESULTS: Of the 2282 studies initially identified, 33 met inclusion criteria. Population health measures were used in 27 studies, with disease-specific measures collected most frequently. Fifteen studies measured cost, most often service utilization. Eight studies measured experience of care, with satisfaction assessed most commonly. Only 3 studies examined all 3 domains of the “Triple Aim.” Transition interventions described in the gray literature were not reviewed. CONCLUSIONS: Transition programs are inconsistently evaluated in terms of their impact on population health, patient experience, and cost. To demonstrate improvement in the transition from pediatric to adult health care, a more robust and consistent set of measures is needed.

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Ohio Study Shows That Insurance Coverage Is Critical For Children With Special Health Care Needs As They Transition To Adulthood

Cited by 22 publications

References 23 publications

Medical Care Transition Planning and Dental Care Use for Youth with Special Health Care Needs During the Transition from Adolescence to Young Adulthood: A Preliminary Explanatory Model

Medical Care Transition Planning and Dental Care Use for Youth with Special Health Care Needs During the Transition from Adolescence to Young Adulthood: A Preliminary Explanatory Model

Health Care Transition Experiences of Males with Childhood-onset Duchenne and Becker Muscular Dystrophy: Findings from the Muscular Dystrophy Surveillance Tracking and Research Network (MD STARnet) Health Care Transitions and Other Life Experiences Survey

Measuring the “Triple Aim” in Transition Care: A Systematic Review

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