Does Parental Health Insurance Loss Affect Children's Access to Care?

描述(由申请人提供) 候选人：德沃博士提议研究失去父母健康保险对儿童获得医疗保健服务的影响。她将继续巩固她坚实的卫生服务研究基础，与支持她成为独立调查员目标的专家导师合作。研究焦点：尽管有医疗补助和州儿童健康保险计划(SCIP)等计划，但美国许多儿童目前没有医疗保险。已有研究表明，扩大父母的覆盖面有助于改善儿童获得医疗保险的机会。关于终止父母保险对儿童的影响，人们知之甚少。俄勒冈州健康计划(OHP)是一项创新的医疗补助扩展计划，最近实施了成本分担措施，导致数千名俄勒冈州父母失去保险。虽然这些OHP政策是针对成年人的，但可能会对儿童产生间接影响。这项建议扩展了当前的研究，旨在关注父母保险损失如何影响儿童获得护理的机会。培训目标：DeVoe博士的培训目标包括：(1)扩大她在大型数据库管理和高级统计分析方面的知识和经验，重点是确定将各州和国家的数据集联系起来的变量，并利用倾向分数和纵向分析技术；(2)通过使用地理信息系统(CIS)软件的正式培训，扩大她进行与政策有关的研究和更有效地传播研究结果的技能。方法：(1)采用横断面分析和地理信息系统空间分析相结合的方法，对全国医疗费用调查和俄勒冈州家长进行调查。(2)对全州范围内正在进行的前瞻性队列研究中的三波调查数据进行纵向分析。结果：我们将衡量父母失去保险和其他儿童保险覆盖障碍与儿童医疗保险参保率、获得医疗服务的机会、医疗服务利用模式和报告的健康状况的差异之间的关系。相关性：这一分析将为试图扩大儿童健康保险覆盖面的州提供有价值的信息，并寻找将障碍降至最低的方法，以使儿童获得保险。

DESCRIPTION (provided by the applicant) CANDIDATE: Dr. DeVoe is proposing to study how loss of parental health insurance affects children's access to health care services. She will continue to build upon her solid health services research foundation by working with expert mentors who support her goal of becoming an independent investigator. RESEARCH FOCUS: Despite programs such as Medicaid and the State Children's Health Insurance Program (SCHIP), many children in the U.S. do not currently have health insurance. It has been shown that expanding parental coverage leads to improved access to health insurance for children. LESS IS KNOWN ABOUT HOW TERMINATION OF PARENTAL COVERAGE AFFECTS CHILDREN. The Oregon Health Plan (OHP), an innovative Medicaid expansion program, has recently implemented cost sharing measures that have led to the loss of coverage for thousands of Oregon parents. Although these OHP policies were aimed at adults, there may be an indirect affect on children. This proposal expands on current research and has been designed to focus on how parental insurance loss is affecting children's access to care. TRAINING GOALS: Dr. DeVoe's training goals include: (1) broadening her knowledge and experience in large database management and advanced statistical analysis, with a focus on identifying variables to link across state and national datasets and the use of propensity scores and longitudinal analytical techniques; and (2) expanding her skills in conducting policy relevant studies and disseminating findings more effectively, with formal training in the use of geographic information system (CIS) software. METHODS: (1) Cross-sectional analysis and GIS spatial analysis of the national Medical Expenditure Panel Survey and a survey of Oregon parents. (2) Longitudinal analysis of three waves of survey data from an ongoing statewide prospective cohort study. OUTCOMES: We will measure how parental loss of insurance and other barriers to children's insurance coverage are associated with differences in children's health insurance enrollment rates, access to health care services, patterns of health services utilization, and reported health status. RELEVANCE: This analysis will provide valuable information for states attempting to expand children's health insurance coverage and looking for ways to minimize barriers in order to keep children insured.