Pediatric CKD patients, public health insurance less likely to see doctor
March 31, 2022
2 minute read
According to data published in Kidney medicine.
Additionally, the researchers called for pediatric nephrology programs to direct support resources to families with public insurance who may be at risk for suboptimal health care utilization. Similarly, insurers could consider expanding access for families with children with CRF.
“The contrast between private and public health insurance in terms of health care and dental care utilization has not been adequately studied in children and young adults with CKD, although disease management and access to clinical care are key to improving outcomes,” Andrea R. Molino, ScM, from the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, and colleagues wrote. “The purpose of this study was to investigate secular trends in health insurance status between 2005 and 2019, and to describe health and dental care utilization by insurance status and potential modifiers in the chronic kidney disease in children (CKiD) study.”
In an observational cohort study, researchers evaluated 953 patients aged 0.5 to 16 years who attended 4,369 person-visits in the CKiD study. Patients and their families provided data on their current health insurance status, whether private, public, or uninsured, and whether they had dental insurance. In addition, patients indicated whether they consulted a private physician in the past year, received treatment from a dentist or dental hygienist, visited the emergency room more twice or not at all and whether they have suffered hospitalizations.
Using repeated measures Poisson regression models, the researchers compared utilization by type of insurance and severity of illness at visits. The researchers ran additional unadjusted and adjusted models, as well as models dealing with interactions between insurance and black race, maternal education, and income.
Overall, 49.2% of patients reported having private health insurance, 49.6% reported having public health insurance, and 1.2% reported having none. Similarly, 25.6% of patients reported having no dental insurance at initial assessment.
Analyzes found that patients with public health insurance were “more likely to report suboptimal healthcare utilization across the spectrum of CKD severity.” The researchers defined “suboptimal health care utilization” as no visits to a private physician, emergency room, or any hospitalization in the past year. Similarly, those without dental insurance were more likely to report a lack of dental care.
“These results suggest that insurance status may be useful in identifying children requiring additional attention directed towards preventive care and support to avoid emergency department visits. We further identified CKD severity as a factor risk of not receiving regular dental care, and that those without dental insurance are at risk of suboptimal dental care utilization,” Molino and colleagues wrote. may consider designing or evaluating interventions to direct support resources to these high-risk patients and families Policy makers may encourage insurance providers to expand access to pediatric CKD preventive care to minimize utilization of emergency health care, and advocating for improved access to services for people with health insurance public.