title: Children's receipt of health care services and family health insurance patterns.
abstract: OBJECTIVE
  Insured children in the United States have better access to health care services; less is known about how parental coverage affects children's access to care. We examined the association between parent-child health insurance coverage patterns and children's access to health care and preventive counseling services.
  
  
  METHODS
  We conducted secondary analyses of nationally representative, cross-sectional, pooled 2002-2006 data from children (n = 43,509), aged 2 to 17 years, in households responding to the Medical Expenditure Panel Survey (MEPS). We assessed 9 outcome measures pertaining to children's unmet health care and preventive counseling needs.
  
  
  RESULTS
  Cross-sectionally, among US children (aged 2 to 17 years) living with at least 1 parent, 73.6% were insured with insured parents, 8.0% were uninsured with uninsured parents, and the remaining 18.4% had discordant family insurance coverage patterns. In multivariable analyses, insured children with uninsured parents had higher odds of an insurance coverage gap (odds ratio [OR] = 2.45; 95% confidence interval [CI], 2.02-2.97), no usual source of care (OR = 1.31; 95% CI, 1.10-1.56), unmet health care needs (OR = 1.11; 95% CI, 1.01-1.22), and having never received at least 1 preventive counseling service (OR = 1.20; 95% CI, 1.04-1.39) when compared with insured children with insured parents. Insured children with mixed parental insurance coverage had similar vulnerabilities.
  
  
  CONCLUSIONS
  Uninsured children had the highest rates of unmet needs overall, with fewer differences based on parental insurance status. For insured children, having uninsured parents was associated with higher odds of going without necessary services when compared with having insured parents.
authors.affiliation: Department of Family Medicine, Oregon Health and Science University, Portland, Oregon 97239, USA. devoej@ohsu.edu
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: DeVoe
authors.forename: Carrie J
authors.initials: CJ
authors.lastname: Tillotson
authors.forename: Lorraine S
authors.initials: LS
authors.lastname: Wallace
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003376:Counseling / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005190:Family; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics* / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D014481:United States