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Insurance coverage and health care use among children with diabetes
Author(s) -
Amin Bina,
Yeduri Rishita,
Tumin Dmitry,
Buckman Cierra,
Bell Jennifer J.
Publication year - 2021
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.13192
Subject(s) - medicine , disadvantaged , odds , odds ratio , health care , public health , family medicine , health insurance , public health insurance , pediatrics , environmental health , nursing , logistic regression , pathology , political science , law , economics , economic growth
Background Health insurance coverage may be associated with pediatric diabetes mellitus (DM) management. However, it is unknown how continuity of insurance coverage is associated with health care use outcomes in pediatric DM. Methods We used the nationally representative 2016–2019 National Survey of Children's Health to examine how interruption of health insurance coverage may affect health care use among children with DM. Children ages 0–17 years with DM were included in the analysis. Outcomes included emergency department visits, specialist visits, and unmet health care needs in the last 12 months. Insurance coverage was classified as continuous private, continuous public, or discontinuous (including gaps in coverage and year‐round lack of coverage). Results Based on a sample of 548 children, 56% percent had continuous private insurance coverage, as compared to 32% with continuous public insurance, and 12% with discontinuous coverage. Thirty‐five percent of children had visited the ED in the past 12 months, and only 47% had visited any specialist in the past 12 months, including but not limited to a pediatric endocrinologist. An estimated 19% of children had unmet health care needs over the past 12 months. On multivariable analysis, children with coverage gaps were significantly less likely than children with continuous private coverage to have a visited a specialist in the past 12 months (adjusted odds ratio: 0.27; 95% CI: 0.08, 0.88; p = 0.030). Conclusions This study points to a need to establish and maintain specialist follow‐up for children with DM, especially those from socioeconomically disadvantaged backgrounds.