207399 Accurately estimating the number of children without access to healthcare

Monday, November 9, 2009: 11:00 AM

Roy Grant, MA , The Children's Health Fund, New York, NY
Deirdre A. Byrne , The Children's Health Fund, New York, NY
Knowing the extent to which children lack healthcare access is essential to health reform. Child healthcare access has generally been measured by the percent and number of children without health insurance for a full year. This is only a partial estimate of the problem. To accurately determine the number of children without adequate healthcare access, we ascertained the inconsistencies and inaccuracies of federal data sources commonly used to estimate uninsured children (MEPS, CPS, NHIS); applied an existing methodology to include partial-year uninsured children; and used original data to estimate the percent and number of children without transportation access to healthcare. We found that federal estimates of uninsured children are limited by sampling bias inherent in survey methodologies including an arbitrary upper age limit (e.g., 17 or 18 years) which understates the percent and number of uninsured youth. Including children with interrupted coverage who are uninsured for part of the year more than doubles the number of children for whom insurance is a barrier to access. The percentage of children who are inadequately insured (e.g., covered for catastrophic illness but not routine and preventive care) is difficult to estimate. An estimated 4% of children nationwide do not have transportation access to healthcare regardless of their insurance status, a problem which especially affects children in health professional shortage areas. When appropriately calculated, the number of children with significant economic and non-economic barriers to healthcare access increases from approximately 8.1 million (full-year uninsured) to more than 20 million children.

Learning Objectives:
At the end of this presentation, participants will be better able to 1. Describe several barriers to child healthcare; 2. Evaluate the validity of federal survey data based on a better understanding of survey methodologies; and 3. Explain why increasing SCHIP enrollment is not enough to ensure child healthcare access

Keywords: Access to Health Care, Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the lead researcher in developing the data necessary to complete this project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.