[ Back to EurekAlert! ] Public release date: 26-Jan-2009
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Contact: Katie Vloet
kgazella@umich.edu
734-764-2220
University of Michigan Health System

Unmet medical needs are most common among vulnerable children

Uninsured children and those without usual source of health care at highest risk, University of Michigan study finds

ANN ARBOR, Mich. — Despite recent government efforts, the medical needs of about six million children in the United States are not being met, according to data from as recent as 2006. Even more troubling, researchers say, is the substantial growth in those numbers, from approximately 4.5 million children in 1998.

Children without insurance and children without a regular source of health care are the most likely to report unmet medical needs, suggesting that improvements are essential in government efforts to address the health of vulnerable children, according to a new study from the University of Michigan C.S. Mott Children's Hospital.

Researchers also found that Hispanic children are uninsured at higher rates and do not have a regular place to seek medical attention—known as a usual source of care (USC). The study appears in the new issue of the journal Pediatrics.

Researchers from the Child Health Evaluation and Research (CHEAR) Unit in the U-M Division of General Pediatrics set out to find how the proportions of publicly insured children (Medicaid and the State Child Health Insurance Program, or SCHIP) and uninsured children without a USC had changed over time (1998-2006).

The time period in the study was chosen so that researchers could evaluate the influence of two federal programs in providing a USC for vulnerable children. SCHIP was initiated by the federal government in 1997 to expand health coverage to children. The President's Health Center Initiative (PHCI) was launched in 2002 with a goal of expanding health centers in medically underserved communities.

Researchers found significant decreases in the proportions of children that were privately insured. In addition, increasing proportions of uninsured children reported having no USC over the study period.

Compared with a child covered with private insurance, the odds of reporting unmet medical needs increased steadily among uninsured children between 1998 and 2006, from 4.7 to 6.2. In addition, the odds of reporting unmet medical needs among children without a USC rose from 3.7 to 5.3 compared with children who identified a private office as a USC.

"Our research shows that these government programs have not yet fully addressed the health care needs of the most vulnerable children," says lead study author Leesha K. Hoilette, M.D., a pediatric health services research fellow with the CHEAR Unit.

"As the nation continues to focus on the future of health care, and, in particular, health care for children, it seems insufficient to focus policy efforts on either health care coverage or access alone," Hoilette says. "Initiatives must be targeted in tandem to increase both coverage and access and reduce unmet medical need."

Researchers analyzed data from the Centers for Disease Control and Prevention's National Health Interview Survey. Their findings show:

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The senior author of the paper was Matthew M. Davis, M.D., M.A.P.P., associate professor of general pediatrics and internal medicine at the Child Health Evaluation and Research (CHEAR) Unit at the U-M Health System; director of the C.S. Mott Children's Hospital National Poll on Children's Health and associate professor of public policy at the Gerald R. Ford School of Public Policy at U-M. Co-authors were Sarah J. Clark, MPH, associate director of research at the Division of General Pediatrics and research assistant professor with the U-M Health System; and Achamyeleh Gebremariam, M.S., with the CHEAR Unit.

This work was supported by the National Institute of Child Health and Human Development T32 HD007534.

Reference: Pediatrics, Vol. 123, Number 2, Feb. 2009.



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