Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton, OH 45404, USA.
J Pediatr. 2013 Feb;162(2):403-8.e1. doi: 10.1016/j.jpeds.2012.07.039. Epub 2012 Aug 23.
To determine the prevalence and correlates of children's underinsurance within a primary care, practice-based research network.
A survey of 13 practices within the Southwestern Ohio Ambulatory Research Network using the Medical Expenses for Children Survey in 2009 and 2010 yielded a sample of 2972 parents of children >6 months old with health insurance in the previous 12 months. Data were analyzed using bivariate and loglinear model analyses.
Of the study children, 17.2% were classified as underinsured because of their inability to pay for ≥ 1 of their pediatrician's recommendations for care in the past 12 months. In addition, 15.5% reported it was harder to get medical care for their child in the past 3 years, and 6.5% indicated that their child's health had suffered. Multivariate analysis reveals complex relationships among the 3 factors related to ability to obtain care and between these factors and sociodemographic and health status factors. Across education and income categories, the underinsured rate ranged from 57% to 93% for parents who reported their child's health had suffered.
One in 6 parents reported that their child was underinsured. A similar percentage reported that it had become more difficult to get needed medical care over the past 3 years. The relationship between the perception that an underinsured child's health has suffered is much stronger for the highest socioeconomic category in this sample than for the other categories; 93% of these families were underinsured in 2009. It is possible that high deductible features of insurance plans contribute to these circumstances.
在初级保健实践研究网络中确定儿童保险不足的患病率及其相关因素。
2009 年和 2010 年，对西南俄亥俄州门诊研究网络中的 13 个实践进行了一项调查，使用儿童医疗费用调查对 2972 名在过去 12 个月中为其有健康保险的 6 个月以上儿童的家长进行了调查。使用双变量和对数线性模型分析对数据进行了分析。
在所研究的儿童中，有 17.2%的儿童因过去 12 个月无法支付儿科医生推荐的 1 项或多项治疗费用而被归类为保险不足。此外，15.5%的家长报告说，在过去 3 年中，他们为孩子获得医疗护理更加困难，6.5%的家长表示孩子的健康受到影响。多变量分析揭示了与获得护理能力相关的 3 个因素之间以及这些因素与社会人口统计学和健康状况因素之间的复杂关系。在教育和收入类别中，对于报告孩子健康状况不佳的家长，保险不足率从 57%到 93%不等。
有 1/6 的家长报告说他们的孩子保险不足。有类似比例的家长报告说，在过去 3 年中，他们更难获得所需的医疗护理。在本样本中，最高社会经济类别的家庭中，认为保险不足的孩子的健康受到影响的比例与其他类别相比要高得多；在 2009 年，这些家庭中有 93%的家庭保险不足。保险计划的高免赔额特征可能是造成这种情况的原因。
