Kogan Michael D, Newacheck Paul W, Honberg Lynda, Strickland Bonnie
Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD 20857, USA.
Pediatrics. 2005 Nov;116(5):1162-9. doi: 10.1542/peds.2004-2432.
To examine the impact of underinsurance on access to care among children with special health care needs (CSHCN) in the United States.
Interviews were conducted by telephone with the families of 38866 CSHCN who were younger than 18 years using the 2001 National Survey of Children With Special Health Care Needs. The prevalence of underinsurance and its relationship to access to care and family financial problems was examined in this cross-sectional analysis. CSHCN were classified as underinsured when coverage was deemed inadequate to meet the child's needs.
An estimated 12.8% of US children experienced a special health care need in 2001. Although 95% of CSHCN had some type of insurance coverage at the time of the interview, 32% were classified as underinsured. Underinsured CSHCN were disproportionately represented in low-income families and were significantly more likely than fully insured children to have unmet health needs, and their families were more likely to report difficulty in obtaining specialty referrals, experience financial problems, and report that the child's condition caused family members to reduce or stop work. Underinsured CSHCN seemed to be somewhat better off than CSHCN with no insurance coverage on these measures.
Underinsured CSHCN represent an important and largely hidden underserved population.
研究保险不足对美国有特殊医疗需求儿童（CSHCN）获得医疗服务的影响。
采用2001年全国有特殊医疗需求儿童调查，通过电话对38866名18岁以下的CSHCN家庭进行访谈。在这项横断面分析中，研究了保险不足的患病率及其与获得医疗服务和家庭财务问题的关系。当保险范围被认为不足以满足儿童需求时，CSHCN被归类为保险不足。
估计2001年美国12.8%的儿童有特殊医疗需求。尽管95%的CSHCN在访谈时有某种类型的保险，但仍有32%被归类为保险不足。保险不足的CSHCN在低收入家庭中所占比例过高，与完全参保的儿童相比，他们有未满足的健康需求的可能性显著更高，他们的家庭更有可能报告在获得专科转诊方面存在困难、经历财务问题，并报告孩子的病情导致家庭成员减少或停止工作。在这些指标上，保险不足的CSHCN似乎比没有保险的CSHCN情况稍好一些。
保险不足的CSHCN是一个重要且很大程度上被忽视的未得到充分服务的人群。
Zotero 插件