- 作者：Megumi J. Okumura ; Melissa L. McPheeters ; Matthew M. Davis
- 关键词：Adolescents ; Insurance coverage ; Transitioning ; Health care utilization ; Children with special health care needs ; Chronic illness ; Medicaid ; SCHIP
- 刊名：Journal of Adolescent Health
- 出版年：2007
- 出版时间：October 2007
- 年：2007
- 卷：41
- 期：4
- 页码：343-349
- 全文大小：113 K
Methods
We used the National Survey of Children’s Health 2003, a nationally representative sample of children in the United States, to study adolescents 14–17 years of age. We present descriptive statistics and regression analyses of adolescents with and without special health care needs, regarding measures of health care use and insurance coverage.
Results
Approximately 22 % of adolescents 14–17 years old have a special health care need. On average, ASHCN have one more annual office visit per year than their non-SHCN peers (p < .001). ASHCN report three times the rate of unmet medical needs compared to their non-SHCN peers (p < .001), despite higher rates of insurance coverage (94 % vs. 88 % , p < .001). Overall, 26.9 % of ASHCN have public coverage. Nationally, more than half of those ASHCN with public coverage report incomes above 100 % of the federal poverty level (FPL), which puts them at risk for losing coverage when they age into adulthood. Across states, proportions of ASHCN on public coverage and with incomes > 100 % FPL range from 3.2 % to 37.5 % .
Conclusions
One in six ASHCN currently has public coverage with household income that would make them ineligible by income criteria for continuing public coverage as adults. It is imperative to examine insurance continuity and corresponding health outcomes for ASHCN as they transition from child to adult health care settings, and to evaluate options for policy interventions that can sustain health care coverage for this vulnerable population.