Heck K E, Makuc D M
National Center for Health Statistics, Hyattsville, Md. 20782, USA.
Am J Public Health. 2000 Dec;90(12):1856-60. doi: 10.2105/ajph.90.12.1856.
This study examined parental employment and health insurance coverage among children with and without special health care needs. Special needs were defined as conditions likely to require a high amount of parental care, potentially affecting parental employment.
Data from the 1994 National Health Interview Survey were analyzed for 21,415 children aged 5 to 17 years, including 1604 children with special needs. Logistic regression was used to estimate the effect of special needs on the odds of full-time parental employment and on the odds of a child's being uninsured, having Medicaid, or having employer-sponsored insurance.
Parents of children with special needs had less full-time employment. Their children had lower odds of having employer-sponsored insurance (adjusted odds ratio [OR] = 0.7) than other children. Children with special needs had greater odds of Medicaid coverage (adjusted OR = 2.3-5.1, depending on family income). Children with and without special needs were equally likely to be uninsured.
Lower full-time employment among parents of children with special needs contributes to the children's being less likely to have employer-sponsored health insurance. Medicaid covers many children with special needs, but many others remain uninsured.
本研究调查了有特殊医疗需求和无特殊医疗需求儿童的父母就业情况及健康保险覆盖情况。特殊需求被定义为可能需要大量父母照料、可能影响父母就业的状况。
对1994年全国健康访谈调查中21415名5至17岁儿童的数据进行分析,其中包括1604名有特殊需求的儿童。采用逻辑回归分析来估计特殊需求对父母全职就业几率以及儿童未参保、参加医疗补助计划(Medicaid)或参加雇主赞助保险几率的影响。
有特殊需求儿童的父母全职就业的比例较低。与其他儿童相比,他们的孩子获得雇主赞助保险的几率较低(调整后的优势比[OR]=0.7)。有特殊需求的儿童获得医疗补助计划覆盖的几率更高(调整后的OR=2.3至5.1,取决于家庭收入)。有特殊需求和无特殊需求的儿童未参保的可能性相同。
有特殊需求儿童的父母全职就业率较低,这导致这些儿童获得雇主赞助健康保险的可能性降低。医疗补助计划覆盖了许多有特殊需求的儿童,但仍有许多儿童未参保。