The Impacts of Health Insurance Coverage on Access to Healthcare in Children Entering Kindergarten
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To examine access to healthcare and health outcomes for kindergartners as they relate to insurance status and type. For the 2008, 2009, and 2010 school years, surveys were distributed to parents with a child entering kindergarten in the state of Nevada. Surveys asked parents to provide information about their child concerning their insurance status, routine medical care, medical conditions, and health behaviors. Compared to their insured peers, uninsured kindergartners were less likely to have had a check-up in the previous 12 months (p < .001; OR 6.14; 95 % CI 5.77–6.53), have a primary physician (p < .001; OR 14.32; 95 % CI 13.49–15.20), or have seen a dentist (p < .001; OR 3.93; 95 % CI 3.70–4.16), and were more likely to have a reported unmet medical need (p < .001; OR 2.60; 95 % CI 2.19–3.07). Additionally, compared to children with private insurance, those children with public insurance were less likely to have had a check-up (p < .001; OR 1.73; 95 % CI 1.59–1.89), have a primary care provider (p < .001; OR 3.87; 95 % CI 3.55–4.21), and were more likely to have unmet medical needs (p < .001; OR 2.27; 95 % CI 1.83–2.81). For children in early development—a deeply critical period—insurance status and type are predictors of important access to healthcare variables.
KeywordsInsurance coverage Medicaid Healthcare disparities Kindergarten Child
Thank you to all the community partners that made this project possible such as all 17 county school districts, the Nevada State Health Division, Southern Nevada Health Department, and the staff at the UNLV Nevada Institute for Children’s Research and Policy. Funding for this project was provided by the Nevada State Health Division.
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