A profile of health problems and quality of care for publicly vs. privately insured children in the US

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.