Soylu Tulay G, Elashkar Eman, Aloudah Fatemah, Ahmed Munir, Kitsantas Panagiota
Department of Health Administration and Policy, George Mason University, Fairfax VA, USA.
J Public Health Res. 2018 Apr 23;7(1):1280. doi: 10.4081/jphr.2018.1280. eCollection 2018 Feb 5.
Surveillance of disparities in healthcare insurance, services and quality of care among children are critical for properly serving the medical/healthcare needs of underserved populations. The purpose of this study was to assess racial/ethnic differences in children's (0 to 17 years old) health insurance adequacy and consistency (child has insurance coverage for the last 12 months).
We used data from the 2011/2012 National Survey of Children's Health (n=79,474). Descriptive statistics and logistic regression analyses were conducted to examine the distribution and influence of several sociodemographic/family related factors on insurance adequacy and consistency across different racial/ethnic groups.
Stratified analyses by race/ethnicity revealed that white and black children living in households at or below 299% of the Federal Poverty Level (FPL) were approximately 29 to 42% less likely to have adequate insurance compared to children living in families of higher income levels. Regardless of race/ethnicity, we found that children with public health insurance were more likely to have adequate insurance than their privately insured counterparts, while adolescents were at greater risk of inadequate coverage. Hispanic and black children were more likely to lack consistent insurance coverage.
This study provides evidence that racial/ethnic differences in adequate and consistent health insurance exists with both white and minority children being affected adversely by poverty. Establishing outreach programs for low income families, and cross-cultural education for healthcare providers may help increase health insurance adequacy and consistency within certain underserved populations.
监测儿童医疗保险、服务及医疗质量方面的差异,对于妥善满足服务不足人群的医疗/保健需求至关重要。本研究的目的是评估儿童(0至17岁)医疗保险充足性和连贯性(儿童在过去12个月有保险覆盖)方面的种族/族裔差异。
我们使用了2011/2012年全国儿童健康调查的数据(n = 79,474)。进行了描述性统计和逻辑回归分析,以检验几个社会人口统计学/家庭相关因素在不同种族/族裔群体中对保险充足性和连贯性的分布及影响。
按种族/族裔进行的分层分析显示,与高收入家庭的儿童相比,生活在联邦贫困线(FPL)299%及以下家庭的白人儿童和黑人儿童拥有充足保险的可能性要低约29%至42%。无论种族/族裔如何,我们发现有公共医疗保险的儿童比有私人保险的儿童更有可能拥有充足保险,而青少年保险覆盖不足的风险更大。西班牙裔和黑人儿童更有可能缺乏连贯的保险覆盖。
本研究提供的证据表明,在医疗保险的充足性和连贯性方面存在种族/族裔差异,白人和少数族裔儿童均受到贫困的不利影响。为低收入家庭建立外展项目,以及为医疗服务提供者开展跨文化教育,可能有助于提高某些服务不足人群的医疗保险充足性和连贯性。