Shepherd-Banigan Megan, Bell Janice F, Basu Anirban, Booth-LaForce Cathryn, Harris Jeffrey R
1 University of Washington, Seattle, WA, USA.
2 University of California Davis, Sacramento, CA, USA.
Med Care Res Rev. 2017 Apr;74(2):208-226. doi: 10.1177/1077558716634555. Epub 2016 Aug 3.
This study examines whether paid sick leave and hours worked per week are associated with receipt of recommended well-child visits, preventive dental care, influenza vaccines, obesity screening, and vision screening among U.S. children aged 0 to 17 years whose mothers were employed using data from the Medical Expenditure Panel Survey. Residual inclusion instrumental variables methods were used to address unobserved confounding related to maternal employment and child health care use. Instruments were the industry-specific mean of paid leave and hours worked. Fewer than half of children received the recommended number of well-child visits and dental care; only 14% of children received an influenza vaccine in the past year. Paid sick leave was associated with increased adherence to recommended well-child visits (marginal probability, 0.12; 95% confidence interval [CI] = 0.23, 0.01), preventive dental care (marginal probability, 0.28; 95% CI = 0.34, 0.33), and receipt of the influenza vaccine (marginal probability, 0.09; 95% CI = 0.13, 0.05 ).
本研究利用医疗支出面板调查的数据，考察了带薪病假和每周工作时长是否与美国0至17岁有工作母亲的儿童接受推荐的健康儿童检查、预防性牙科护理、流感疫苗接种、肥胖筛查及视力筛查有关。采用残差纳入工具变量法来处理与母亲就业及儿童医疗保健利用相关的未观察到的混杂因素。工具变量为各行业带薪休假和工作时长的均值。不到一半的儿童接受了推荐次数的健康儿童检查和牙科护理；过去一年中只有14%的儿童接种了流感疫苗。带薪病假与增加对推荐的健康儿童检查（边际概率为0.12；95%置信区间[CI]=0.23, 0.01）、预防性牙科护理（边际概率为0.28；95% CI = 0.34, 0.33）及流感疫苗接种（边际概率为0.09；95% CI = 0.13, 0.05）的依从性有关。
