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The Impact of Parental Health Insura...

Akobirshoev, Ilhom.

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The Impact of Parental Health Insurance on Health Outcomes and Health Care Utilization For Insured Children.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	The Impact of Parental Health Insurance on Health Outcomes and Health Care Utilization For Insured Children./
作者:	Akobirshoev, Ilhom.
面頁冊數:	162 p.
附註:	Source: Dissertation Abstracts International, Volume: 77-02(E), Section: A.
Contained By:	Dissertation Abstracts International77-02A(E).
標題:	Public policy. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3723584
ISBN:	9781339063942

The Impact of Parental Health Insurance on Health Outcomes and Health Care Utilization For Insured Children.
Akobirshoev, Ilhom.

The Impact of Parental Health Insurance on Health Outcomes and Health Care Utilization For Insured Children. - 162 p.

Source: Dissertation Abstracts International, Volume: 77-02(E), Section: A.

Thesis (Ph.D.)--Brandeis University, The Heller School for Social Policy and Management, 2015.

Providing children but not their parents with health insurance coverage could have serious implication for a child's health, a child's health care service utilization, and subsequent related social costs. This is a three-paper dissertation, consisting of three separate research questions and three separate analyses, each of which is presented below.

ISBN: 9781339063942Subjects--Topical Terms:

532803
Public policy.

The Impact of Parental Health Insurance on Health Outcomes and Health Care Utilization For Insured Children.
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245 1 4 $a The Impact of Parental Health Insurance on Health Outcomes and Health Care Utilization For Insured Children.
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500 $a Source: Dissertation Abstracts International, Volume: 77-02(E), Section: A.
500 $a Adviser: Diana Bowser.
502 $a Thesis (Ph.D.)--Brandeis University, The Heller School for Social Policy and Management, 2015.
520 $a Providing children but not their parents with health insurance coverage could have serious implication for a child's health, a child's health care service utilization, and subsequent related social costs. This is a three-paper dissertation, consisting of three separate research questions and three separate analyses, each of which is presented below.
520 $a The first analysis used the Person-Process-Context-Time (PPCT) model of Bronfenbrenner's ecological systems theory (Bronfenbrenner, 1979, 2005) as the theoretical basis to evaluate the effect of parental uninsurance and the mediating effect of parental health on a child's health status. Using data from 2006--2013 National Health Interview Survey (NHIS), Kenny's mediation approach (Baron and Kenny, 1986; MacKinnon, Lockwood, Hoffman, West, & Sheets, 2002) was used to estimate the effect of parental uninsurance on a child's health outcomes, and whether parental health status mediated this relationship. This analysis finds that insured children who live with uninsured parents are significantly more likely to have decreased health status and are significantly more likely to have chronic illnesses including asthma, diabetes, ADHD, developmental delay, learning disability, and mental disability, when compared to children with insured parents, controlling for available relevant covariates derived from the PPCT model of ecological systems theory. This analysis also finds that parental health is a significant mediating mechanism between parental uninsurance and a child's health status and the selected health conditions including asthma, autism, diabetes, ADHD, developmental delay, learning disability, mental disability. Findings from this analysis underscore the importance of the pathway between policies that provide health insurance coverage to both parents and children within the same family to improved parental health status and better health status for the insured child. Providing health insurance coverage to uninsured parents has a positive impact on health outcomes for both parents and children, including reduced risks of asthma, autism, diabetes, ADHD, developmental delay, learning disability, and mental disability all of which have long-term consequences.
520 $a The second analysis used the Andersen and Aday's behavioral model to estimate the relationship between parental uninsurance and a child's access to and utilization of heath care services. Using combined data from the 2006--2013 National Health Interview Survey (NHIS), logistic regression approach was used to estimate the effect of parental uninsurance on a child's health care service utilization. The odds ratios from logistic regression models, similar to previous research, reveal a significant and inverse relationship between parental uninsurance and their insured children's use of health care services. This analysis finds that insured children with uninsured parents are significantly more likely not to have usual source of health care and more likely to miss well-child care visits. Results from this analysis indicate that, policies that provide family health insurance coverage to families where children are insured but parents are uninsured, can significantly improve a child's access to health care services.
520 $a The third analysis examines the social benefits of providing family health insurance coverage to families where children are insured but parents are uninsured. The net social benefits were evaluated by comparing the social costs of health care services utilization for the two different groups; families with family health insurance coverage (both parents and children were insured) versus families with discordant family health insurance coverage (children were insured but parents were uninsured). The analysis finds that compared to families with family health insurance coverage, families with discordant family health insurance coverage have significantly higher social costs of health care services utilization ($16,381 per family vs. $14,150 per family). The main drivers of increased social cost among families with discordant family health insurance coverage are increased use of emergency department services ($181 per family vs. $138 per family) and inpatient hospital services ($12,936 per family vs. $9,212 per family). Findings from this study indicate that, policies that provide family health insurance coverage to families with discordant family health insurance coverage can confer significant social benefits.
520 $a Findings from these three analyses provide strong evidence that policies that provide family health insurance coverage to families where children are insured but parents are uninsured, have a significant multiplier effect. Family health insurance coverage also confers social benefits due to preventing treatment of avoided chronic health conditions in children, avoided incremental cost and uncompensated care due to excessive use of emergency department and inpatient hospital services. Findings from this dissertation provide an early assessment of the potential outcomes of Affordable Care Act (ACA) implementation if previously uninsured parents gain insurance status through the ACA. (Abstract shortened by UMI.).
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