Relationship between health insurance coverage and childhood asthma-related outcomes

Recent research has shown that healthcare coverage is related to diagnosis of asthma and treatment, including asthma-related hospitalizations. However, one study found that excess emergency department (ED) visits by black children are not attributable to different types of health insurance coverage. We studied the relationship between type of insurance and medication and ED/urgent care usage among children under 18 years of age. Data from the 2005 and 2006 North Carolina Child Health Assessment and Monitoring Program (CHAMP) Surveys were used for bivariate and multiple logistic regression analyses to determine predictors of three asthma management behaviors. Children who currently had asthma and with private insurance were significantly less likely to take asthma medications every day [OR=0.54 (CI=0.35-0.85) p=.008] than those with public insurance. They were also significantly less likely to report an ED/urgent care visit [OR=0.29 (CI=0.10-0.82) p=.0195] than those with no insurance. No significant relationships were found between type of insurance and rescue medication usage. Even after controlling for age, gender, and race, the results show that the relationship between type of insurance coverage and childhood asthma management behavior varies depending on the current status of the child's asthma. CHAMP data are useful for exploring healthcare access issues among children with asthma.