A Usual Source of Care Supplement or Substitute for Health Insurance Among Low-Income Children?
A Usual Source of Care Supplement or Substitute for Health Insurance Among Low-Income Children?
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DOI：
10.1097/mlr.0b013e3181866443
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发表时间：
2008-10-01
期刊：
影响因子：
3
通讯作者：
Krois, Lisa
中科院分区：
文献类型：
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作者：
DeVoe, Jennifer E.;Petering, Ryan;Krois, Lisa
目标：研究健康保险和常规护理来源 (USC) 对低收入儿童获得医疗保健的单独和综合影响，并确定其中之一在确保更好地获得必要服务方面是否更胜一筹。方法：我们对俄勒冈州食品券计划邮件退回调查的数据进行了横断面、多变量分析。已完成的 2681 项调查的结果经过对过采样技术和无答复的调整后，被加权回 84,087 个家庭的人口。结果：在俄勒冈州低收入儿童中，拥有健康保险和南加州大学的儿童获得医疗保健的机会最好。与该参考组进行多变量比较时，没有 USC 的受保儿童未满足医疗需求的比例较高[比值比 (OR) = 2.18；比值比 (OR) = 2.18； 95%置信区间（CI）：1.27-3.73]； 12 个月内没有去看医生（OR = 6.77；95% CI：3.80-12.06）；以及获得特殊护理的问题（OR = 4.12；95% CI：1.59-10.68）。同样，拥有 USC 但没有健康保险的医疗需求未得到满足的可能性更高（OR = 4.33；95% CI：2.85-6.57）：与 Mullet 处方需求一样（OR = 164 95% CI：1.77-3.94）。以及获得牙科护理的问题（OR = 4.83；95% CI：3.31-7.06）。结论：正在提出增量政策解决方案，重点关注儿童的健康保险覆盖范围或扩大初级保健的覆盖范围。然而，这两种方法都不能取代另一种方法的需要。 USC 和健康保险的作用共同构成了儿童获得必要医疗保健服务的最佳机会的可能性的附加预测因素。
Objectives: To examine the Separate and combined effects of having health insurance and a usual source of care (USC) on access to healthcare for low-income children and to determine if one or the other is superior in ensuring better access to necessary services.Methods: We conducted cross-sectional, multivariable analyses of data from a mail-return survey of Oregon's food stamp program. Results from 2681 completed surveys were weighted back to a Population of 84,087 families with adjustments for oversampling techniques and nonresponse.Results: Among low-income Oregon children, those with health insurance and a USC reported the best access to healthcare. In multivariable comparison to this reference group, insured children without a USC had higher rates of unmet medical need [odds ratio (OR) = 2.18; 95% confidence interval (CI): 1.27-3.73]; no doctor visits in 12 months (OR = 6.77; 95% CI: 3.80-12.06); and problems obtaining specialty care (OR = 4.12; 95% CI: 1.59-10.68). Similarly, having a USC but not health insurance was associated with an even higher likelihood of unmet medical needs (OR = 4.33; 95% CI: 2.85-6.57): as Welt as Mullet prescription needs (OR = 164 95% CI: 1.77-3.94). and problems obtaining dental care (OR = 4.83; 95% CI: 3.31-7.06).Conclusions: Incremental Policy Solutions are being proposed that focus on either health insurance coverage for children or expanded access to primary care. However, neither approach displaces the need for the other. The effects of a USC and health insurance, together, are additive predictors of the likelihood that children have optimal access to necessary healthcare services.