Underinsurance in Children with Special Health Care Needs: The Impact of Definition on Findings

To identify differences in groups of children with special healthcare needs (CSHCN) identified as underinsured by two alternate definitions and discuss implications for policy decisions based on using one definition over another. Secondary data from the National Survey of CSHCN 2005/2006 were analyz...

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Bibliographic Details
Published in:Maternal and child health journal 2013-10, Vol.17 (8), p.1478-1487
Main Authors: Preskitt, Julie K., McEldowney, Rene P., Mulvihill, Beverly A., Wingate, Martha S., Menachemi, Nir
Format: Article
Language:English
Subjects:
Access control
Adolescent
Analysis of Variance
Caregivers
Child
Child Health Services - economics
Child, Preschool
Children & youth
Childrens health
Demographics
Disabled Children
Economics
Female
Gynecology
Health care
Health care expenditures
Health Care Surveys
Health insurance
Health Services Accessibility
Health Services Needs and Demand
Humans
Infant
Infant, Newborn
Insurance coverage
Insurance Coverage - economics
Insurance Coverage - statistics & numerical data
Insurance, Health
Male
Maternal & child health
Maternal and Child Health
Medically Uninsured - statistics & numerical data
Medicine
Medicine & Public Health
Out-of-pocket expenses
Pediatrics
Population Economics
Public Health
Socioeconomic Factors
Sociology
Uninsured people
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Description
Summary:To identify differences in groups of children with special healthcare needs (CSHCN) identified as underinsured by two alternate definitions and discuss implications for policy decisions based on using one definition over another. Secondary data from the National Survey of CSHCN 2005/2006 were analyzed. Only CSHCN who were continuously-insured for 12 months were included in analyses. We identified groups of underinsured CSHCN using two general definitions (“economic” and “attitudinal”) and three mutually-exclusive groups (identified by both definitions, identified by attitudinal but not economic, and identified by economic but not attitudinal). Key variables included demographics and condition characteristics. Different underinsurance rates were identified [attitudinal = 30.9 % (n = 11,470); economic = 22.7 % (n = 8,447)] with fair agreement by kappa score (κ = 0.3194; Z = 65.91; p  > 0.0001). Differences across mutually-exclusive groups included family income ≥400 % FPL (attitudinal only = 34.2 %, economic only = 16.3 %, both = 18.4 %; p  
ISSN:1092-7875
1573-6628
DOI:10.1007/s10995-012-1155-z