Trends in Type of Health Insurance Coverage for US Children and Their Parents, 1998–2011

DeVoe, Jennifer E.; Tillotson, Carrie J.; O’Malley, Jean P.; Angier, Heather; Wallace, Lorraine S.; Gold, Rachel

doi:10.1016/j.acap.2015.06.009

Cited by 6 publications

(3 citation statements)

References 31 publications

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“…Conversely, the percentage of those with private insurance decreased to 37.8% from 51% for the same timeframe . This change in insurance type corresponds appropriately with the trend observed from 1998 to 2011, during which there was an overall increase in the percentage of children insured by Medicaid and a concomitant decrease in private insurance . Therefore, there does not appear to be a higher proportion of tracheostomy patients with Medicaid compared to the general population of hospitalized patients.…”

Section: Discussionsupporting

confidence: 75%

Tracheostomy demographics and outcomes among pediatric patients ages 18 years or younger—United States 2012

et al. 2018

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Objectives/Hypothesis: To estimate the number, demographics, and outcomes of pediatric patients who underwent tracheostomy in 2012 and to contrast those outcomes by age, race, and gender.Study Design: Cross-sectional study. Methods: The 2012 Kids Inpatient Database was queried to identify tracheostomy patients using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedural codes 311, 3121, and 3129. All patients ≤18 years of age at the time of admission were included and categorized as neonates (≤28 days), infants (>28 days ≤1 year), toddler (1 to 3 years), children (4 to 12 years), adolescents (13 to 17 years), and adults (=18 years). We recorded age, gender, race, insurance status, and zip code of primary residence. We used these variables to contrast the following outcomes: length of stay, total charges, complications of care, and mortality using multiple regression analysis.Results: An estimated 4,424 pediatric tracheostomies occurred during 2012. Fifty-one percent of the patients were ≤3 years old, and 62% were male. Forty-eight percentwere white followed by black (21%), Hispanic (20%), and Asian (3%). The median length of stay was 42 days, and the median total charges were $472,738. The complication rate was 29% and the mortality rate was 8.0%. The length of stay and total charges was predicted by age, with neonates having significantly longer hospitalizations. The complication rate was not associated with age, gender, or ethnicity. However, the mortality rate was associated with younger age.Conclusions: Pediatric tracheostomies are associated with significant hospital utilizations, complications, and mortality. Increased risk of mortality is observed among neonates and infants. Continued study of tracheostomy outcomes among these subsets of the pediatric population are warranted.

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Section: Discussionsupporting

confidence: 75%

Tracheostomy demographics and outcomes among pediatric patients ages 18 years or younger—United States 2012

et al. 2018

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“…In 2020, the median household income in Hispanic/Latinx households working full-time was $55,321, compared with $74,912 for non-Hispanic households 57 . Income plays a major role in advancing disparities in health care in every facet, including access to health insurance, 58 transportation to healthcare appointments, 59 treatment center type, 60 increased morbidities, 61 etc. This also leads to a decrease in quality of life, which has been shown to result in worse radiation treatment adherence 62 …”

Section: Discussionmentioning

confidence: 99%

Disparities in Access to Radiotherapy Among Hispanic/Latinx Populations in the United States

Verdini,

Santos,

Vicioso-Mora

et al. 2023

American Journal of Clinical Oncology

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Objectives: The Hispanic/Latinx population has consistently faced disparities in oncology access and outcomes with cancer being the leading cause of death in this population. We evaluate recent research in radiation therapy disparities among the Hispanic/Latinx population in the United States since our seminal analysis from 2017. Methods: A PubMed literature search was conducted for articles published from January 2017 through March 2023. Four term combinations were utilized, including: (1) “Hispanic” and “Radiotherapy” and “Disparities”, (2) “Latino” and “Radiotherapy” and “Hispanic”, (3) “Hispanic” and “Radiation” and “Disparities”, and (4) “Latino” and “Radiation” and “Disparities.” Included studies were those taking place in the United States, examined radiation oncology care, and examined health disparities. Results: Fifty-eight of 245 articles returned met inclusion criteria and spanned 6 disparity-types: (1) Stage at Presentation, (2) Time to Treatment Initiation & Completion, (3) Receipt of Treatment and Guideline-Concordant Care, (4) Geography, (5) Clinical Trial Access and (6) Insurance Barriers and Treatment Center Type. The most common disparity was receipt of treatment and guideline-concordant care (n=39 studies), demonstrating that the Hispanic/Latinx population was less likely to receive guideline-concordant treatment or treatment at all. In additon, studies identified disparities in time to treatment and completion (n=12), geography (n=5), clinical trial access (n=3), and insurance and treatment center access (n=5). Conclusions: Disparities in radiotherapy access remain prominent for the Hispanic/Latinx population through a multitude of barriers, despite increasing interest in disparities research. Continued health care disparities research with tangible interventions are needed in radiation oncology to properly understand and address this problem.

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“…[ 17 ] Recent expansions in public insurance in the United States (through Medicaid and the Children's Health Insurance Program, CHIP) over the past decade have substantially increased the health insurance coverage of children, leading to better access to health care services. [ 18 , 19 ] At the same time, the cost of dependent coverage under employed-sponsored insurance has increased over time, leading more parents to forgo enrolling their children under their private insurance and enrolling them in public insurance instead. [ 20 , 21 ] A report by the Government Accountability Office estimated that between 2005 and 2007 about 4% of children (or about 3 million) in the United States had public insurance while their parent were privately insured.…”

Section: Introductionmentioning

confidence: 99%

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

King

2016

Medicine

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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.

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Trends in Type of Health Insurance Coverage for US Children and Their Parents, 1998–2011

Cited by 6 publications

References 31 publications

Tracheostomy demographics and outcomes among pediatric patients ages 18 years or younger—United States 2012

Tracheostomy demographics and outcomes among pediatric patients ages 18 years or younger—United States 2012

Disparities in Access to Radiotherapy Among Hispanic/Latinx Populations in the United States

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

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