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Physician insurance surveillance could increase child coverage
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Insurance surveillance could help physicians assist uninsured patients obtain coverage, according to recent study findings.
Brigit Hatch, MD, of Oregon Health and Science University, and colleagues found that nearly one-third of patients who were uninsured at their first visit were still uninsured at subsequent visits. Electronic health record (EHR) data were used for all children who presented (n=185,959) to the OCHIN Network of community health centers in Oregon from 2010 to 2011 to compare uninsured children with those with insurance and subsequent insurance status.
Twenty-one percent of children did not have insurance at their first visit during the study period, 12% had commercial insurance and 67% had Medicaid. Among those uninsured at the first visit, 30% were still uninsured at subsequent visits; 19% obtained Medicaid for at least one subsequent visit; 4% gained commercial insurance for a subsequent visit; and 47% did not remain in the system.
There also were significant differences among the characteristics of children who were insured and uninsured. Nonwhite and/or Hispanic children had lower odds of being uninsured than having Medicaid/Medicare compared with white, non-Hispanic children (adjusted OR=0.73; 95% CI, 0.71-0.75). However, they had higher odds of being uninsured than having commercial insurance (adjusted OR=1.5; 95% CI, 1.44-1.56).
Children aged 15 to 18 years had higher odds of being uninsured than having Medicaid/Medicare coverage compared with younger children (adjusted OR=1.87; 95% CI, 1.82-1.92) but had lower odds of being uninsured than having commercial coverage (adjusted OR=0.81; 95% CI, 0.78-0.84).
“EHRs provide new opportunities for identifying uninsured populations and tracking insurance coverage in populations at risk for discontinuous coverage,” the researchers wrote. “EHRs can facilitate insurance surveillance and inform clinic-based interventions aimed at helping patients obtain and retain insurance coverage.”
Disclosure: The study was funded by the Agency for Healthcare Research and Quality, the Patient-Centered Outcomes Research Institute, and the Oregon Health & Science University, Department of Family Medicine. Hatch reports no relevant financial disclosures.
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