Continuity of insurance coverage and ambulatory care-sensitive hospitalizations/ED visits

Evidence from the children's health insurance program

David J. Becker, Justin Blackburn, Meredith L. Kilgore, Michael A. Morrisey, Bisakha Sen, Cathy Caldwell, Nir Menachemi

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: To assess the effects of continuity of insurance coverage on treatment of ambulatory-care sensitive conditions (ACSC). Study Population: 42,382 children enrolled in ALL Kids (Alabama Children's Health Insurance Program) for 3 or more years. Methods: We model annual hospitalizations and ED visits for six ACSCs identified by the AHRQ - bacterial pneumonia, dehydration, perforated appendix, urinary tract infection, gastroenteritis, and severe ear, nose and throat infection. Results: In unadjusted models, we find lower risk of ACSC hospitalizations and ED visits in the second and third years of continuous enrollment. Risk of hospitalization in year 3 was significantly lower for pneumonia (OR 0.608, 95% CI: 0.421-0.878) and gastroenteritis (OR 0.549, 95% CI: 0.404-0.746). These beneficial effects of duration of coverage disappear after controlling for age, year and other enrollee characteristics. Conclusions: Hospitalizations and ED visits for ACSCs are rare and do not decrease with additional years of coverage.

Original languageEnglish (US)
Pages (from-to)963-973
Number of pages11
JournalClinical Pediatrics
Volume50
Issue number10
DOIs
StatePublished - Oct 1 2011
Externally publishedYes

Fingerprint

Insurance Coverage
Ambulatory Care
Hospitalization
Gastroenteritis
Bacterial Pneumonia
Appendix
Pharynx
Dehydration
Nose
Urinary Tract Infections
Ear
Pneumonia
Children's Health Insurance Program
Infection
Population
Therapeutics

Keywords

  • ambulatory care sensitive conditions
  • Children's Health Insurance Program
  • continuity of coverage
  • quality

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Continuity of insurance coverage and ambulatory care-sensitive hospitalizations/ED visits : Evidence from the children's health insurance program. / Becker, David J.; Blackburn, Justin; Kilgore, Meredith L.; Morrisey, Michael A.; Sen, Bisakha; Caldwell, Cathy; Menachemi, Nir.

In: Clinical Pediatrics, Vol. 50, No. 10, 01.10.2011, p. 963-973.

Research output: Contribution to journalArticle

Becker, David J. ; Blackburn, Justin ; Kilgore, Meredith L. ; Morrisey, Michael A. ; Sen, Bisakha ; Caldwell, Cathy ; Menachemi, Nir. / Continuity of insurance coverage and ambulatory care-sensitive hospitalizations/ED visits : Evidence from the children's health insurance program. In: Clinical Pediatrics. 2011 ; Vol. 50, No. 10. pp. 963-973.
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