title: Parents' perspectives on their children's health insurance: plight of the underinsured.
abstract: OBJECTIVE
  To determine the prevalence and correlates of children's underinsurance within a primary care, practice-based research network.
  
  
  METHODS
  A survey of 13 practices within the Southwestern Ohio Ambulatory Research Network using the Medical Expenses for Children Survey in 2009 and 2010 yielded a sample of 2972 parents of children >6 months old with health insurance in the previous 12 months. Data were analyzed using bivariate and loglinear model analyses.
  
  
  RESULTS
  Of the study children, 17.2% were classified as underinsured because of their inability to pay for ≥ 1 of their pediatrician's recommendations for care in the past 12 months. In addition, 15.5% reported it was harder to get medical care for their child in the past 3 years, and 6.5% indicated that their child's health had suffered. Multivariate analysis reveals complex relationships among the 3 factors related to ability to obtain care and between these factors and sociodemographic and health status factors. Across education and income categories, the underinsured rate ranged from 57% to 93% for parents who reported their child's health had suffered.
  
  
  CONCLUSIONS
  One in 6 parents reported that their child was underinsured. A similar percentage reported that it had become more difficult to get needed medical care over the past 3 years. The relationship between the perception that an underinsured child's health has suffered is much stronger for the highest socioeconomic category in this sample than for the other categories; 93% of these families were underinsured in 2009. It is possible that high deductible features of insurance plans contribute to these circumstances.
authors.affiliation: Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton, OH 45404, USA. William.spears@wright.edu
authors.forename: William
authors.initials: W
authors.lastname: Spears
authors.forename: John
authors.initials: J
authors.lastname: Pascoe
authors.forename: Harry
authors.initials: H
authors.lastname: Khamis
authors.forename: Caroline I
authors.initials: CI
authors.lastname: McNicholas
authors.forename: Greg
authors.initials: G
authors.lastname: Eberhart
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007348:Insurance, Health; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D010290:Parents