Carter Tracy M, Adams Marsha Howell, Judd Alesa Hicks, Leeper James D, Wang Lei, Yu Jing
J Rural Health. 2003 Fall;19(4):511-3. doi: 10.1111/j.1748-0361.2003.tb00590.x.
This study examines the relationship between children's health insurance status and utilization of health services, establishment of a medical home, and unmet health needs over a 3-year period (1996-1998) in a rural Alabama K-12 school system.
As part of a children's health insurance outreach program, questionnaires were administered to parents of 754 children regarding health and health care access. In addition, noninvasive head-to-toe physical assessments of children were conducted on-site at 4 schools.
A relationship between health care utilization and insurance status was observed. Results found that insured children had 1.183 (P < .0115) times the number of medical visits as uninsured children. Among uninsured children, the time since last dental visit was 1.6 (P < .001) times longer than that of insured children. Also, insured children were 5.21 times more likely than uninsured (P < .0001) to report having a medical home. No significant differences between insured and uninsured children were found regarding unmet health needs as measured by referrals made after the children's physical assessments.
Child health coverage is an important determining factor in the ability of families to access and utilize health care services. These findings have implications for populations in similar rural communities across the nation.
本研究调查了阿拉巴马州农村K - 12学校系统中，1996年至1998年这3年期间儿童的健康保险状况与医疗服务利用、医疗之家的建立以及未满足的健康需求之间的关系。
作为儿童健康保险推广项目的一部分，对754名儿童的家长进行了关于健康和医疗保健获取情况的问卷调查。此外，还在4所学校对儿童进行了现场非侵入性的从头到脚身体评估。
观察到医疗保健利用与保险状况之间存在关联。结果发现，参保儿童的就诊次数是未参保儿童的1.183倍（P <.0115）。在未参保儿童中，自上次看牙以来的时间是参保儿童的1.6倍（P <.001）。此外，参保儿童报告有医疗之家的可能性是未参保儿童的5.21倍（P <.0001）。根据儿童身体评估后转诊情况衡量，参保儿童和未参保儿童在未满足的健康需求方面没有显著差异。
儿童健康保险覆盖范围是家庭获取和利用医疗保健服务能力的一个重要决定因素。这些发现对全国类似农村社区的人群具有启示意义。
