Maternal and Child Health Journal

, Volume 15, Issue 8, pp 1238–1248 | Cite as

Comparing Type of Health Insurance Among Low-Income Children: A Mixed-Methods Study from Oregon

  • Jennifer E. DeVoe
  • Lorraine Wallace
  • Shelley Selph
  • Nicholas Westfall
  • Stephanie Crocker


We employed a mixed-methods study of primary data from a statewide household survey and in-person interviews with parents to examine—quantitatively and qualitatively—whether low-income children experienced differences between public and private insurance coverage types. We carried out 24 in-depth interviews with a subsample of respondents to Oregon’s 2005 Children’s Access to Healthcare Study (CAHS), analyzed using a standard iterative process and immersion/crystallization cycles. Qualitative findings guided quantitative analyses of CAHS data that assessed associations between insurance type and parental-reported unmet children’s health care needs. Interviewees uniformly reported that stable health insurance was important, but there was no consensus regarding which type was superior. Quantitatively, there were only a few significant differences. Cross-sectionally, compared with private coverage, public coverage was associated with higher odds of unmet specialty care needs (odds ratio [OR] 3.54; 95% confidence interval [CI] 1.52–8.24). Comparing full-year coverage patterns, those with public coverage had lower odds of unmet prescription needs (OR 0.60, 95% CI 0.36–0.99) and unmet mental health counseling needs (OR 0.24, 95% CI 0.10–0.63), compared with privately covered children. Low-income Oregon parents reported few differences in their child’s experience with private versus public coverage.


Child health insurance Child access to care Medicaid CHIP Health services research Health policy Health care disparities 


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Jennifer E. DeVoe
    • 1
  • Lorraine Wallace
    • 2
  • Shelley Selph
    • 3
  • Nicholas Westfall
    • 4
  • Stephanie Crocker
    • 4
  1. 1.Department of Family MedicineOregon Health and Science UniversityPortlandUSA
  2. 2.Department of Family MedicineUniversity of Tennessee Graduate School of MedicineKnoxvilleUSA
  3. 3.Department of Medical Informatics and Clinical EpidemiologyOregon Health and Science UniversityPortlandUSA
  4. 4.School of MedicineOregon Health and Science UniversityPortlandUSA

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