title: A recession's impact on pediatric emergency household spending and attitudes about health-care reform.
abstract: BACKGROUND
  We assessed changes in household spending and opinions about health-care insurance reform among parents in the pediatric emergency department (PED) during the current recession.
  
  
  METHODS
  We conducted a survey of parents at a PED. Enrollment was in June and July 2009. We assessed demographics, employment and insurance status, and difficulty paying for household expenses. Open-ended questions addressed attitudes about health-care reform.
  
  
  RESULTS
  Among 467 parents, job loss was associated with difficulty paying for food (OR 2.32, 95% CI 1.53-3.52), housing (3.21, 2.11-4.88), and utilities (2.19, 1.44-3.32). In total, 226 respondents cut household expenses. More respondents cut food expenses (20.8%) and utilities (15.8%) than child health care (12.0%). Of 154 respondents providing opinions about health-care reform, 66.9% endorsed reform, and 9.7% disagreed.
  
  
  CONCLUSIONS
  Parents with job loss reported hardship paying for household expenses. One in eight families have cut child health-care expenses. A population of PED parents commonly favored health-care insurance reform.
authors.affiliation: Yale New-Haven Children's Hospital, Emergency Department, 840 Howard Avenue, New Haven, CT 06504, USA. mark.cicero@yale.edu
authors.forename: Mark X
authors.initials: MX
authors.lastname: Cicero
authors.forename: Veronika
authors.initials: V
authors.lastname: Northrup
authors.forename: Fang-Yong
authors.initials: FY
authors.lastname: Li
authors.forename: Karen A
authors.initials: KA
authors.lastname: Santucci
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003237:Connecticut; D003430:Cross-Sectional Studies; D057172:Economic Recession; D004636:Emergency Service, Hospital / Q000191:economics*; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data; D018166:Health Care Reform; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006785:Hospitals, University; D006786:Hospitals, Urban; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D010290:Parents; D010372:Pediatrics / Q000191:economics*; D014478:Unemployment / Q000706:statistics & numerical data; D055815:Young Adult