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移民家庭中儿童的公共医疗保险与医疗保健利用情况

Public Health Insurance and Health Care Utilization for Children in Immigrant Families.

作者信息

Percheski Christine, Bzostek Sharon

机构信息

Department of Sociology and Institute for Policy Research, Northwestern University, 1812 Chicago Avenue, Evanston, IL, 60208, USA.

Department of Sociology and Institute for Health, Health Care Policy & Aging Research, Rutgers University, New Brunswick, NJ, USA.

出版信息

Matern Child Health J. 2017 Dec;21(12):2153-2160. doi: 10.1007/s10995-017-2331-y.

Abstract

Objectives To estimate the impacts of public health insurance coverage on health care utilization and unmet health care needs for children in immigrant families. Methods We use survey data from National Health Interview Survey (NHIS) (2001-2005) linked to data from Medical Expenditures Panel Survey (MEPS) (2003-2007) for children with siblings in families headed by at least one immigrant parent. We use logit models with family fixed effects. Results Compared to their siblings with public insurance, uninsured children in immigrant families have higher odds of having no usual source of care, having no health care visits in a 2 year period, having high Emergency Department reliance, and having unmet health care needs. We find no statistically significant difference in the odds of having annual well-child visits. Conclusions for practice Previous research may have underestimated the impact of public health insurance for children in immigrant families. Children in immigrant families would likely benefit considerably from expansions of public health insurance eligibility to cover all children, including children without citizenship. Immigrant families that include both insured and uninsured children may benefit from additional referral and outreach efforts from health care providers to ensure that uninsured children have the same access to health care as their publicly-insured siblings.

摘要

目标

评估公共医疗保险覆盖范围对移民家庭中儿童医疗保健利用情况及未满足的医疗保健需求的影响。方法:我们使用了来自国家健康访谈调查(NHIS)(2001 - 2005年)的调查数据,并将其与医疗支出面板调查(MEPS)(2003 - 2007年)的数据相链接,这些数据涉及至少有一位移民家长的家庭中有兄弟姐妹的儿童。我们使用了具有家庭固定效应的logit模型。结果:与有公共保险的兄弟姐妹相比,移民家庭中未参保的儿童更有可能没有常规的医疗保健来源、在两年内没有进行过医疗保健就诊、高度依赖急诊部门以及有未满足的医疗保健需求。我们发现年度健康儿童检查的几率没有统计学上的显著差异。实践结论:先前的研究可能低估了公共医疗保险对移民家庭中儿童的影响。移民家庭中的儿童可能会从扩大公共医疗保险资格范围以覆盖所有儿童(包括无公民身份的儿童)中受益匪浅。包括参保和未参保儿童的移民家庭可能会受益于医疗保健提供者额外的转诊和外展努力,以确保未参保儿童能与参保的兄弟姐妹一样获得医疗保健服务。

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