278545
A profile of health problems and quality of care for publicly vs. privately insured children in the US
Wednesday, November 6, 2013
: 8:30 a.m. - 8:50 a.m.
Christina Bethell, PhD, MBA, MPH,
Department of Pediatrics, School of Medicine, The Child and Adolescent Health Measurement Initiative, Oregon Health & Science University, Portland, OR
Michael D. Kogan, PhD,
Office of Epidemiology and Research, HRSA / Maternal and Child Health Bureau, Rockville, MD
Bonnie B. Strickland, PhD,
Maternal and Child Health Bureau/Division of Services for Children with Special Health Care Needs, Health Resources and Services Administration, Rockville, MD
Edward Schor, MD,
Lucile Packard Foundation for Children's Health, Palo Alto, CA
Paul Newacheck, DrPH,
Institute of Health Policy Studies, University of California, San Francisco, San Francisco, CA
Eva Hawes, MPH, CHES,
Department of Pediatrics, School of Medicine, The Child and Adolescent Health Measurement Initiative, Oregon Health & Science University, Portland, OR
Susan Carson, MPH,
Department of Pediatrics, School of Medicine, The Child and Adolescent Health Measurement Initiative, Oregon Health & Science University, Portland, OR
Caryn Snyder, MPH,
Department of Pediatrics, School of Medicine, The Child and Adolescent Health Measurement Initiative, Oregon Health & Science University, Portland, OR
The Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 seeks to expand insurance coverage and ensure quality of care provided for children under the Children's Health Insurance Program and Medicaid. The currently embargoed 2011/12 National Survey of Children's Health (NSCH) is the most recent national and state-specific sample of children that allows identification of differences in health problems and system quality by insurance source and across states. Utilizing baseline data provided in the 2007 NSCH, we compared 5 summary health status and 10 system quality indicators aligned with CHIPRA priorities. Changes in child health insurance status (publicly insured, privately insured, and uninsured) and disparities in quality of care between health insurance types are examined for national rates and variations across states and for subgroups of children. Health status measures identify the population of children within each insurance type, and quality of care measures identify the disparities in care provided. A minimal quality of care summary measure (adequate health insurance, preventive medical care, and medical home) provides a standard of care that all children should be receiving. Logistic regression analyses will determine the independent effect of public (vs private) insurance and socioeconomic status on variations in health and system quality for children. By understanding disparities in health and quality of health care delivery between publicly and privately insured children, policymakers can seek to work toward eliminating discrepancies and promote quality health care for all children.
Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Public health administration or related administration
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health
Learning Objectives:
Assess the potential impact of quality of care since the implementation of CHIPRA legislation regarding health problems and system performance.
Describe changes in health problems and quality of care provided for children with public vs. private insurance
Analyze disparities in health and health care quality, and potential policies that can build upon existing priorities set forth in the legislation
Keyword(s): Quality of Care, Health Insurance
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am a research associate with The Child and Adolescent Health Measurement Initiative (CAHMI) and Data Resource Center for Child and Adolescent Health (DRC), where our mission is to advance a patient-centered health care system. Easy access to children's health data through the DRC allows researchers, policymakers, family advocates and consumers to work together to promote a higher quality health care system for children, youth and families.
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.
