Discontinuous insurance coverage among children; results from the Ohio Family Health Survey

The magnitude and impact of discontinuous health insurance has been examined in studies using national survey data. These studies measured the association between insurance coverage and unmet needs, accounting for covariates including predisposition to using, needs for, and enablers of service. It is difficult to make generalizations at the state level as differing program characteristics affect enrollment and retention. Also, these studies did not account for the duration of partial insurance.

This study utilized data from the Ohio Family Health Survey conducted from Oct 2003 to July 2004. We analyzed data on 15,447 children up to 17 years of age. Questions on health status, insurance status and access to and utilization of care were consistent with questions from the National Health Interview Surveys. Using a logistic regression model, we compared children with partial insurance to those uninsured or insured for a full year.

We found associations between insurance status and unmet needs consistent with results reported from national surveys (OR 3.1 for unfilled prescriptions to 14.3 for usual source of care). We also found that the proportion of children delaying care, not having a usual source of care, not having a doctor visit in the past year, and having other unmet needs increased an average 12% from a short duration of uninsured (1 - 3 months) to a longer duration (6 + months without coverage during the year).

In the midst of SCHIP renewal, these results may help States to project the impact of strategies to ensure continuous coverage.