Phoenix Children's Hospital, Oregon Health and Science University, Portland OR, USA.
Matern Child Health J. 2013 Feb;17(2):248-55. doi: 10.1007/s10995-012-0968-0.
Parent's insurance coverage is associated with children's insurance status, but little is known about whether a parent's coverage continuity affects a child's coverage. This study assesses the association between an adult's insurance continuity and the coverage status of their children. We used data from a subgroup of participants in the Oregon Health Care Survey, a three-wave, 30-month prospective cohort study (n = 559). We examined the relationship between the length of time an adult had health insurance coverage and whether or not all children in the same household were insured at the end of the study. We used a series of univariate and multivariate logistic regression models to identify significant associations and the rho correlation coefficient to assess collinearity. A dose response relationship was observed between continuity of adult coverage and the odds that all children in the household were insured. Among adults with continuous coverage, 91.4% reported that all children were insured at the end of the study period, compared to 83.7% of adults insured for 19-27 months, 74.3% of adults insured for 10-18 months, and 70.8% of adults insured for fewer than 9 months. This stepwise pattern persisted in logistic regression models: adults with the fewest months of coverage, as compared to those continuously insured, reported the highest odds of having uninsured children (adjusted odds ratio 7.26, 95% confidence interval 2.75, 19.17). Parental health insurance continuity is integral to maintaining children's insurance coverage. Policies to promote continuous coverage for adults will indirectly benefit children.
家长的保险覆盖范围与子女的保险状况有关，但对于家长的保险覆盖连续性是否会影响子女的保险覆盖范围知之甚少。本研究评估了成年人保险连续性与子女保险状况之间的关系。我们使用了俄勒冈州医疗保健调查的参与者的一个子组的数据，这是一项三波、30 个月的前瞻性队列研究（n=559）。我们研究了成年人拥有医疗保险覆盖范围的时间长短与研究结束时同一家庭中所有儿童是否参保之间的关系。我们使用一系列单变量和多变量逻辑回归模型来确定显著关联，并用 rho 相关系数来评估共线性。在成年人的保险连续性和家庭中所有儿童参保的可能性之间观察到了剂量反应关系。在连续性保险的成年人中，91.4%的人报告说，在研究期末所有儿童都参保了，而在保险期限为 19-27 个月的成年人中，这一比例为 83.7%，在保险期限为 10-18 个月的成年人中，这一比例为 74.3%，在保险期限少于 9 个月的成年人中，这一比例为 70.8%。这种逐步的模式在逻辑回归模型中持续存在：与连续参保的成年人相比，保险期限最短的成年人报告说，其子女未参保的可能性最高（调整后的优势比为 7.26，95%置信区间为 2.75，19.17）。父母的健康保险连续性是维持儿童保险覆盖范围的关键。促进成年人连续参保的政策将间接地使儿童受益。
