Dataset Information

The impact of gaps in health insurance coverage on immunization status for young children.

ABSTRACT: OBJECTIVE: To examine the impact of full-year versus intermittent public and private health insurance coverage on the immunization status of children aged 19-35 months. DATA SOURCE: 2001 State and Local Area Integrated Telephone Survey's National Survey of Children with Special Health Care Needs (NS-CSHCN) and the 2000-2002 National Immunization Survey (NIS). STUDY DESIGN: Linked health insurance data from 2001 NS-CSHCN with verified immunization status from the 2000-2002 NIS for a nationally representative sample of 8,861 nonspecial health care needs children. Estimated adjusted rates of up-to-date (UTD) immunization status using multivariate logistic regressions for seven recommended immunizations and three series. PRINCIPAL FINDINGS: Children with public full-year coverage were significantly more likely to be UTD for two series of recommended vaccines, (4:3:1:3) and (4:3:1:3:3), compared with children with private full-year coverage. For three out of 10 immunizations and series tested, children with private part-year coverage were significantly less likely to be UTD than children with private full-year coverage. CONCLUSIONS: Our findings raise concerns about access to needed immunizations for children with gaps in private health insurance coverage and challenge the prevailing belief that private health insurance represents the gold standard with regard to UTD status for young children.

SUBMITTER: Blewett LA

PROVIDER: S-EPMC2653891 | biostudies-other | 2008 Oct

REPOSITORIES: biostudies-other

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The impact of gaps in health insurance coverage on immunization status for young children.

Blewett Lynn A LA Davidson Gestur G Bramlett Matthew D MD Rodin Holly H Messonnier Mark L ML

Health services research 20080603 5 Pt 1

<h4>Objective</h4>To examine the impact of full-year versus intermittent public and private health insurance coverage on the immunization status of children aged 19-35 months.<h4>Data source</h4>2001 State and Local Area Integrated Telephone Survey's National Survey of Children with Special Health Care Needs (NS-CSHCN) and the 2000-2002 National Immunization Survey (NIS).<h4>Study design</h4>Linked health insurance data from 2001 NS-CSHCN with verified immunization status from the 2000-2002 NIS ...[more]

PMID: 18522671

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Project description:BACKGROUND: China has one of the world's largest health insurance systems, composed of government-run basic health insurance and commercial health insurance. The basic health insurance has undergone system-wide reform in recent years. Meanwhile, there is also significant development in the commercial health insurance sector. A phone call survey was conducted in three major cities in China in July and August, 2011. The goal was to provide an updated description of the effect of health insurance on the population covered. Of special interest were insurance coverage, gross and out-of-pocket medical cost and coping strategies. RESULTS: Records on 5,097 households were collected. Analysis showed that smaller households, higher income, lower expense, presence of at least one inpatient treatment and living in rural areas were significantly associated with a lower overall coverage rate. In the separate analysis of basic and commercial health insurance, similar factors were found to have significant associations. Higher income, presence of chronic disease, presence of inpatient treatment, higher coverage rates and living in urban areas were significantly associated with higher gross medical cost. A similar set of factors were significantly associated with higher out-of-pocket cost. Households with lower income, inpatient treatment, higher commercial insurance coverage, and living in rural areas were significantly more likely to pursue coping strategies other than salary. CONCLUSIONS: The surveyed cities and surrounding rural areas had socioeconomic status far above China's average. However, there was still a need to further improve coverage. Even for households with coverage, there was considerable out-of-pocket medical cost, particularly for households with inpatient treatments and/or chronic diseases. A small percentage of households were unable to self-finance out-of-pocket medical cost. Such observations suggest possible targets for further improving the health insurance system.

Dataset Information

The impact of gaps in health insurance coverage on immunization status for young children.

Publications

The impact of gaps in health insurance coverage on immunization status for young children.

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