The study was partially funded by a grant to the Oregon Office for Health Policy and Research from the Health Resources and Services Administration. Dr DeVoe’s time on this project was partially supported by grant numbers 5-F32-HS014645 and 1-K08-HS16181 from the Agency for Healthcare Research and Quality and by the OHSU Department of Family Medicine Research Division.
State Children’s Health Insurance Program (U.S.), Medically uninsured children -- Oregon
BACKGROUND AND OBJECTIVES: The State Children's Health Insurance Program (SCHIP) has improved insurance coverage rates. However, children's enrollment status in SCHIP frequently changes, which can leave families with uncertainty about their children's coverage status. We examined whether insurance uncertainty was associated with unmet health care needs.
METHODS: We compared self-reported survey data from 2,681 low-income Oregon families to state administrative data and identified children with uncertain coverage. We conducted cross-sectional multivariate analyses using a series of logistic regression models to test the association between uncertain coverage and unmet health care needs. RESULTS: The health insurance status for 13.2% of children was uncertain. After adjustments, children in this uncertain "gray zone" had higher odds of reporting unmet medical (odds ratio [OR] =1.73; 95% confidence interval [CI]=1.07, 2.79), dental (OR=2.41; 95% CI=1.63, 3.56), prescription (OR=1.64, 95% CI=1.08, 2,48), and counseling needs (OR=3.52; 95% CI=1.56, 7.98), when compared with publicly insured children whose parents were certain about their enrollment status.
CONCLUSIONS: Uncertain children's insurance coverage was associated with higher rates of unmet health care needs. Clinicians and educators can play a role in keeping patients out of insurance gray zones by (1) developing practice interventions to assist families in confirming enrollment and maintaining coverage and (2) advocating for policy changes that minimize insurance enrollment and retention barriers.
Devoe JE, Ray M, Krois L, Carlson MJ. Uncertain health insurance coverage and unmet children’s healthcare needs. Family Medicine 2010;42(2):121-32.