Table 5.
Associations Between Uncertain Health Insurance Coverage (Being in an Insurance Gray Zone) and Children’s Unmet Health Care Needs
| Access Measure |
% Reporting Children’S Health
Care Access Difficulties (Weighted) |
Multivariate
Odds Ratio * |
P Value** |
|---|---|---|---|
|
| |||
| Unmet medical need | (Total 16.0%) | ||
| Child has OHP (public insurance) | 12.7 | 1.00 | P<.001 |
| Child has private insurance | 14.4 | 1.37 (0.88, 2.14) | |
| Child is in health insurance “gray zone” | 21.1 | 1.73 (1.07, 2.79) | |
| Child is uninsured | 41.9 | 4.33 (2.79, 6.73) | |
| (unweighted n=2,236, weighted n=70,088) | |||
|
| |||
| Unmet prescription need | |||
| Child has OHP (public insurance) | (Total 22.1%) | ||
| Child has private insurance | 18.4 | 1.00 | P<.001 |
| Child is in health insurance “gray zone” | 29.9 | 1.77 (1.22, 2.56) | |
| Child is uninsured | 26.4 | 1.64 (1.08, 2.48) | |
| (unweighted n=2,215, weighted n=69,557) | 37.7 | 2.46 (1.61, 3.76) | |
|
| |||
| Missed medication doses | |||
| Child has OHP (public insurance) | (Total 10.7%) | ||
| Child has private insurance | 8.8 | 1.00 | P<.001 |
| Child is in health insurance “gray zone” | 15.2 | 1.87 (1.09, 3.19) | |
| Child is uninsured | 12.5 | 1.38 (0.83, 2.28) | |
| (unweighted n=2,226, weighted n=69,853) | 19.0 | 2.36 (1.34, 4.15) | |
|
| |||
| No doctor visits | |||
| Child has OHP (public insurance) | (Total 13.8%) | ||
| Child has private insurance | 10.6 | 1.00 | P<.001 |
| Child is in health insurance “gray zone” | 11.0 | 1.02 (0.59, 1.77) | |
| Child is uninsured | 17.8 | 1.08 (0.63, 1.84) | |
| (unweighted n=2,259, weighted n=70,902) | 41.3 | 2.68 (1.62, 4.44) | |
|
| |||
| Big problem getting dental care | |||
| Child has OHP (public insurance) | (Total 25%) | ||
| Child has private insurance | 20.5 | 1.00 | P<.001 |
| Child is in health insurance “gray zone” | 21.6 | 0.88 (0.59, 1.30) | |
| Child is uninsured | 38.5 | 2.41 (1.63, 3.56) | |
| (unweighted n=2,209, weighted n=69,341) | 61.5 | 5.58 (3.70, 8.43) | |
|
| |||
| Rarely or never got immediate care1 | |||
| Child has OHP (public insurance) | (Total 21.6%) | ||
| Child has private insurance | 18.5 | 1.00 | P<.001 |
| Child is in health insurance “gray zone” | 12.8 | 0.68 (0.38, 1.22) | |
| Child is uninsured | 31.9 | 2.17 (1.30, 3.63) | |
| (unweighted n=1,522, weighted n=48,389) | 50.3 | 3.92 (2.29, 6.69) | |
|
| |||
| Big problem getting specialty care2 | |||
| Child has OHP (public insurance) | (Total 29.5%) | P<.05 | |
| Child has private insurance | 27.0 | 1.00 | |
| Child is in health insurance “gray zone” | 21.0 | 0.39 (0.18, 0.88) | |
| Child is uninsured | 38.9 | 1.37 (0.67, 2.80) | |
| (unweighted n=570, weighted n=18,060) | 45.2 | 1.30 (0.56, 3.00) | |
|
| |||
| Big problem getting counseling3 | |||
| Child has OHP (public insurance) | (Total 21%) | ||
| Child has private insurance | 16.5 | 1.00 | P<.05 |
| Child is in health insurance “gray zone” | 32.9 | 2.34 (1.03, 5.33) | |
| Child is uninsured | 27.3 | 3.52 (1.56, 7.98) | |
| (unweighted n=519, weighted n=16,399) | 35.5 | 5.07 (2.02, 12.69) | |
OHP—Oregon Health Plan (combined Medicaid and State Children’s Health Insurance Program)
Note: Gray zone group above combines both child OHP enrolled, unaware (child was administratively OHP enrolled but self-reported not being enrolled) and child uninsured, unaware (not administratively enrolled in OHP but self-reported OHP enrolled), which are shown separately in Table 4.
P value in the χ2 analysis for overall differences between the four groups.
Adjusted for child’s gender, child’s age, child’s race/ethnicity, parental employment, parental insurance status, geographic region, monthly household income, whether or not child has a special health care need (yes/no), whether or not child has a usual source of care (yes/no).
Only among children who needed immediate care in the previous 12 months;
Only among children who needed specialty care in the previous 12 months;
Only among children who needed counseling in the previous 12 months.