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APHA Scientific Session and Event Listing

Shana A. Lavarreda, MPP¹, Melissa Gatchell, MPH², Ninez Ponce, MPP, PhD³, E. Richard Brown, PhD⁴, and Y. Jenny Chia, PhD¹. (1) Center for Health Policy Research, UCLA, 10960 Wilshire Blvd., Suite 1550, Los Angeles, CA 90024, 310-794-2261, shana@ucla.edu, (2) Health Services, UCLA School of Public Health, Box 951772, Los Angeles, CA 90095-1772, (3) Department of Health Services, UCLA, 31-254B CHS, Los Angeles, CA 90095-1772, (4) Department of Community Health Sciences, University of California, Los Angeles, School of Public Health, 10833 Le Conte Ave., Los Angeles, CA 90095

During the course of the previous year, as many persons switched insurance as were uninsured all year, but the research existing on the impact this change in coverage has on access to care is more limited than the volumes of evidence that being uninsured undermines health care access. The objective of this study is to determine whether switching insurance during the past year has a detrimental effect on basic access to care, even if the person is never uninsured. Multivariate logistical and Poisson regressions are applied to data from the 2003 California Health Interview Survey (CHIS 2003), one of the largest population-based health surveys in the nation. CHIS 2003 is a random-digit-dial telephone survey to 42,044 households in California, excluding institutionalized settings and cell phones, administered from August 2003 to February 2004. A total of 13,062 children, ages 0-18, and 32,850 adults, ages 19-64, from CHIS 2003 were included in the study population. We examined whether changing insurance affected self-reports of having a usual source of care, the number of doctor visits in the past year, and any delays in care because of cost or insurance. Initial findings from CHIS 2001 data indicate that both children and adults experienced a disruption in their basic access to health care when they switched insurance plans or types over the course of the past year, even if they were never uninsured. These findings highlight the need for and importance of adequate retention of enrollees as one avenue for preserving access to health care.

Learning Objectives:

• Analyze the extent of the impact of switching health insurance on access to care.
• Identify specific populations most at risk of disrupting their access to care because of switching insurance.
• Evaluate the disparate impact of switching between or among public and private types of health insurane on access to care.

Keywords: Insurance, Access and Services

Presenting author's disclosure statement:

Any relevant financial relationships? No