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Table 3 Comparison of outcomes for uninsured vs. insured children at one-year follow-upa

From: The health and healthcare impact of providing insurance coverage to uninsured children: A prospective observational study

Outcome

Proportion (%) or Mean for

P

Uninsured Group (n = 41)

Insured Group (n = 196)

Health status

 Health status not excellent/very goodb

19 (46%)

53 (27%)

.01

 Parent worries about child’s health more than other people

31 (76%)

133 (68%)

.35

 Parent has emotional worry or concern about child’s physical health

27 (66%)

110 (56%)

.27

 PedsQL total score

90 ± 11.4

89 ± 13.6

.59

Access to healthcare

 Child has no PCP

28 (68%)

36 (18%)

<.0001

 Child has no usual source of preventive care

8 (20%)

1 (0.5%)

<.0001

 Never/sometimes gets immediate care from PCPc

2 (40%)

3 (7%)

.02

 Child has no usual source of sick care

5 (12%)

6 (3%)

.01

 Different source of sick care and preventive care

23 (56%)

27 (14%)

<.0001

 Has no 24-h telephone coverage for sick care

33 (80%)

111 (57%)

.004

 Usual source of care has no night or weekend office hours

30 (73%)

119 (61%)

.13

Never/sometimes can obtain after-hours telephone help or adviced

1 (50%)

6 (29%)

.52

Unmet healthcare needs

 Delayed or didn’t get needed healthcare

20 (48%)

25 (13%)

<.0001

 Didn’t receive all needed preventive caree

11 (50%)

9 (6%)

<.0001

 Didn’t receive all needed acute caref

2 (25%)

4 (9%)

.17

 Didn’t receive all needed specialty careg

1 (33%)

5 (18%)

.52

 Didn’t receive all needed dental careh

16 (62%)

29 (18%)

<.0001

 Didn’t receive all needed prescription medicationsi

0 (0%)

3 (3%)

.53

 Didn’t receive all needed medical supplies or equipmentj

6 (46%)

12 (23%)

.09

Use of health servicesk

 Doctor visits in past year

2.1 ± 0.5

2.9 ± 0.2

.01

 Preventive-care visits in past year

0.7 ± 0.1

1.2 ± 0.1

.01

 Sick visits in past year

1.2 ± 0.5

1.7 ± 0.2

.03

 ED visits in past year

0.4 ± 0.2

0.3 ± 0.1

.91

 Hospital stays in past year

0.05 ± 0.05

0.03 ± 0.02

.71

Quality of pediatric care (scale of 1–10, where 10 = best)l

 Rating of overall quality of child’s well-child visit

8.0 ± 0.3

8.9 ± 0.1

.01

 Rating of child’s PCP

8.4 ± 0.5

9.2 ± 0.1

.16

 Rating of child’s acute care

8.5 ± 0.4

9.1 ± 0.1

.17

 Quality rating of child’s specialty care

6.8 ± 1.7

8.8 ± 0.3

.30

Parental satisfaction with care

 Doctor never/sometimes takes time to understand child’s specific needs

14 (34%)

28 (14%)

.01

 Doctor never/sometimes respects you are expert on your child

12 (29%)

27 (14%)

.02

 Doctor never/sometimes asks how you are feeling as parent

23 (56%)

91 (46%)

.26

 Doctor never/sometimes understands how your prefer to raise child

17 (41%)

56 (29%)

.10

 Doctor did not spend enough time with child

4 (10%)

19 (10%)

.99

 Did not ask all questions I wanted to ask

5 (13%)

10 (5%)

.08

 Would not recommend child’s healthcare provider to friends

10 (24%)

15 (8%)

<.0001

Satisfaction with process of obtaining insurance

  

<.0001

 Very satisfied

4 (10%)

93 (48%)

 

 Satisfied

7 (18%)

71 (37%)

 

 Uncertain

11 (28%)

18 (9%)

 

 Dissatisfied

8 (20%)

7 (4%)

 

 Very dissatisfied

10 (25%)

5 (3%)

 

Parental out-of-pocket costs of pediatric carek

 Mean out-of-pocket cost per doctor visit

$70 ± 15

$29 ± 15

<.0001

 Mean out-of-pocket cost per preventive-care visit

$67 ± 29

$9 ± 3

.01

 Mean out-of-pocket cost per sick visit

$86 ± 18

$16 ± 4

<.0001

 Mean out-of-pocket cost per ED visit

$146 ± 75

$77 ± 63

.01

 Mean out-of-pocket cost per hospital stay

$25 ± 25

$0 ± 0

.33

Parental-reported financial burden

 Need additional income to cover child’s medical expenses

12 (29%)

10 (5%)

.01

 Child’s health caused financial problem for family

12 (29%)

13 (7%)

.01

 Family cut down on work hours to obtain healthcare for child

3 (7%)

12 (6%)

.81

 Stopped working because of child’s health

3 (7%)

5 (3%)

.12

Missed school and work days due to child’s healthk

 Missed school days in past year

2.1 ± 0.4

2.5 ± 0.3

.34

 Missed work days in past year due to child’s illness

0.5 ± 0.2

0.7 ± 0.2

.41

 Wage loss in past year due to missed work days

$1237 ± 1038

$490 ± 229

.50

 Other costs related to taking care of sick child

$6030 ± 5970

$622 ± 342

.02

  1. aPlus-minus values are means ±SD, except where noted. PCP denotes primary-care provider, and PedsQL denotes Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales
  2. bBy caregiver report
  3. cAmong the N = 48 who reported that their child needed immediate care from the PCP
  4. dAmong the N = 23 who reported that they needed after-hours telephone help or advice and had one-year follow-up data
  5. eAmong the N = 170 who reported that their child needed preventive care
  6. fAmong the N = 129 who reported that their child needed acute care
  7. gAmong the N = 53 who reported that their child needed specialty care
  8. hAmong the N = 192 who reported that their child needed dental care
  9. iAmong the N = 132 who reported that their child needed prescription medications
  10. jAmong the N = 61 who reported that their child needed medical supplies or equipment
  11. kPlus-minus values are means ±SE
  12. lBy caregiver report, using a scale of 0–10, in which 0 = worst possible rating and 10 = best possible rating