Davidoff Amy, Dubay Lisa, Kenney Genevieve, Yemane Alshadye
Urban Institute, Washington DC 20037, USA.
Inquiry. 2003 Fall;40(3):254-68. doi: 10.5034/inquiryjrnl_40.3.254.
This study examines the effects of having an uninsured parent on access to health care for low-income children. Using data from the 1999 National Survey of America's Families, we find that having an uninsured parent decreases the likelihood that a child will have any medical provider visit by 6.5 percentage points, and decreases the likelihood of a well-child visit by 6.7 percentage points. Estimates for low-income children who have insurance but have an uninsured parent indicate a 4.1 percentage-point reduction in the probability of having any medical provider visit, and a similar 4.2 percentage-point reduction in the probability of having a well-child visit relative to those with insured parents. The effects of having an uninsured parent are smaller in magnitude than the effects of a child being uninsured. Efforts to increase insurance coverage of parents, either by extending eligibility for public insurance or through other policy interventions, will have positive spillover effects on access to care for children. Although the magnitude of these effects is small relative to the direct effect of providing insurance to either the child or parent, they should be considered in analyses of costs and benefits of proposed policies.
本研究考察了父母无保险对低收入儿童获得医疗保健的影响。利用1999年美国全国家庭调查的数据,我们发现,父母无保险会使儿童去看任何医疗服务提供者的可能性降低6.5个百分点,使儿童进行健康体检的可能性降低6.7个百分点。对于有保险但父母无保险的低收入儿童,与父母有保险的儿童相比,他们去看任何医疗服务提供者的概率降低4.1个百分点,进行健康体检的概率也有类似的4.2个百分点的降低。父母无保险的影响在程度上小于儿童无保险的影响。通过扩大公共保险资格或其他政策干预措施来提高父母保险覆盖率的努力,将对儿童获得医疗服务产生积极的溢出效应。尽管相对于为儿童或父母提供保险的直接影响而言,这些影响的程度较小,但在分析拟议政策的成本和收益时应予以考虑。