Comparing type of health insurance among low-income children: a mixed-methods study from Oregon.
We employed a mixed-methods study of primary data from a statewide household survey and in-person interviews with parents to examine-quantitatively and qualitatively-whether low-income children experienced differences between public and private insurance coverage types. We carried out 24 in-depth interviews with a subsample of respondents to Oregon's 2005 Children's Access to Healthcare Study (CAHS), analyzed using a standard iterative process and immersion/crystallization cycles. Qualitative findings guided quantitative analyses of CAHS data that assessed associations between insurance type and parental-reported unmet children's health care needs. Interviewees uniformly reported that stable health insurance was important, but there was no consensus regarding which type was superior. Quantitatively, there were only a few significant differences. Cross-sectionally, compared with private coverage, public coverage was associated with higher odds of unmet specialty care needs (odds ratio [OR] 3.54; 95% confidence interval [CI] 1.52-8.24). Comparing full-year coverage patterns, those with public coverage had lower odds of unmet prescription needs (OR 0.60, 95% CI 0.36-0.99) and unmet mental health counseling needs (OR 0.24, 95% CI 0.10-0.63), compared with privately covered children. Low-income Oregon parents reported few differences in their child's experience with private versus public coverage.
Department of Family Medicine, Oregon Health and Science University, 3181 Sam Jackson Park Rd, mailcode: FM, Portland, OR 97239, USA. devoej@ohsu.edu
Jennifer E
JE
DeVoe
Lorraine
L
Wallace
Shelley
S
Selph
Nicholas
N
Westfall
Stephanie
S
Crocker
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D006291:Health Policy; D006301:Health Services Needs and Demand; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D007348:Insurance, Health / Q000145:classification* / Q000706:statistics & numerical data; D007407:Interviews as Topic; D017057:Medically Uninsured; D009922:Oregon; D011203:Poverty; D017149:Private Sector; D017150:Public Sector