School of Social Service Administration, University of Chicago, Chicago, IL 60637, USA.
Med Care Res Rev. 2011 Oct;68(5):523-36. doi: 10.1177/1077558711398877.
Many children with health insurance will experience gaps in coverage over time, potentially reducing their access to and use of preventive health care services. This article uses the Survey of Income and Program Participation to examine how the stability of children's health insurance changed between 1990 and 2005 and to identify dynamic aspects of family life associated with transitions in coverage. Children's health insurance instability has increased since the early 1990s, due to greater movement between insured and uninsured states and between private and public insurance coverage. Changes in the employment and marital status of the family head are highly associated with an increased risk of a child losing and gaining public and private coverage, largely in hypothesized directions. The exception is that marital dissolution and job loss are associated with an increased probability of a child losing public insurance, despite there being no clear policy explanation for such a relationship.
许多有医疗保险的儿童随着时间的推移会经历保障范围的缺口,这可能会降低他们获得和使用预防保健服务的机会。本文利用收入和计划参与调查(Survey of Income and Program Participation)来研究儿童医疗保险的稳定性在 1990 年至 2005 年间是如何变化的,并确定与保险范围变化相关的家庭生活的动态方面。自 20 世纪 90 年代初以来,由于参保和未参保状态之间以及私人保险和公共保险之间的流动增加,儿童医疗保险的不稳定状况有所加剧。家庭主要成员的就业和婚姻状况的变化与儿童失去和获得公共和私人保险的风险增加高度相关,在很大程度上符合假设的方向。例外情况是,尽管没有明确的政策解释表明这种关系的存在,但婚姻破裂和失业与儿童失去公共保险的概率增加有关。