State and National Estimates of Insurance Coverage and Health Care Utilization for Adolescents with Chronic Conditions from the National Survey of Children's Health, 2003

Megumi J. Okumura*, Melissa L. McPheeters, Matthew M. Davis

*Corresponding author for this work

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Purpose: To examine health and insurance characteristics of adolescents with special health care needs (ASHCN), at state and federal levels. Methods: We used the National Survey of Children's Health 2003, a nationally representative sample of children in the United States, to study adolescents 14-17 years of age. We present descriptive statistics and regression analyses of adolescents with and without special health care needs, regarding measures of health care use and insurance coverage. Results: Approximately 22% of adolescents 14-17 years old have a special health care need. On average, ASHCN have one more annual office visit per year than their non-SHCN peers (p < .001). ASHCN report three times the rate of unmet medical needs compared to their non-SHCN peers (p < .001), despite higher rates of insurance coverage (94% vs. 88%, p < .001). Overall, 26.9% of ASHCN have public coverage. Nationally, more than half of those ASHCN with public coverage report incomes above 100% of the federal poverty level (FPL), which puts them at risk for losing coverage when they age into adulthood. Across states, proportions of ASHCN on public coverage and with incomes > 100% FPL range from 3.2% to 37.5%. Conclusions: One in six ASHCN currently has public coverage with household income that would make them ineligible by income criteria for continuing public coverage as adults. It is imperative to examine insurance continuity and corresponding health outcomes for ASHCN as they transition from child to adult health care settings, and to evaluate options for policy interventions that can sustain health care coverage for this vulnerable population.

Original languageEnglish (US)
Pages (from-to)343-349
Number of pages7
JournalJournal of Adolescent Health
Volume41
Issue number4
DOIs
StatePublished - Oct 1 2007

Keywords

  • Adolescents
  • Children with special health care needs
  • Chronic illness
  • Health care utilization
  • Insurance coverage
  • Medicaid
  • SCHIP
  • Transitioning

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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