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Table 3 Comparison of outcomes for uninsured vs. insured children at one-year follow-upa

From: The health and healthcare impact of providing insurance coverage to uninsured children: A prospective observational study

Outcome Proportion (%) or Mean for P
Uninsured Group (n = 41) Insured Group (n = 196)
Health status
 Health status not excellent/very goodb 19 (46%) 53 (27%) .01
 Parent worries about child’s health more than other people 31 (76%) 133 (68%) .35
 Parent has emotional worry or concern about child’s physical health 27 (66%) 110 (56%) .27
 PedsQL total score 90 ± 11.4 89 ± 13.6 .59
Access to healthcare
 Child has no PCP 28 (68%) 36 (18%) <.0001
 Child has no usual source of preventive care 8 (20%) 1 (0.5%) <.0001
 Never/sometimes gets immediate care from PCPc 2 (40%) 3 (7%) .02
 Child has no usual source of sick care 5 (12%) 6 (3%) .01
 Different source of sick care and preventive care 23 (56%) 27 (14%) <.0001
 Has no 24-h telephone coverage for sick care 33 (80%) 111 (57%) .004
 Usual source of care has no night or weekend office hours 30 (73%) 119 (61%) .13
Never/sometimes can obtain after-hours telephone help or adviced 1 (50%) 6 (29%) .52
Unmet healthcare needs
 Delayed or didn’t get needed healthcare 20 (48%) 25 (13%) <.0001
 Didn’t receive all needed preventive caree 11 (50%) 9 (6%) <.0001
 Didn’t receive all needed acute caref 2 (25%) 4 (9%) .17
 Didn’t receive all needed specialty careg 1 (33%) 5 (18%) .52
 Didn’t receive all needed dental careh 16 (62%) 29 (18%) <.0001
 Didn’t receive all needed prescription medicationsi 0 (0%) 3 (3%) .53
 Didn’t receive all needed medical supplies or equipmentj 6 (46%) 12 (23%) .09
Use of health servicesk
 Doctor visits in past year 2.1 ± 0.5 2.9 ± 0.2 .01
 Preventive-care visits in past year 0.7 ± 0.1 1.2 ± 0.1 .01
 Sick visits in past year 1.2 ± 0.5 1.7 ± 0.2 .03
 ED visits in past year 0.4 ± 0.2 0.3 ± 0.1 .91
 Hospital stays in past year 0.05 ± 0.05 0.03 ± 0.02 .71
Quality of pediatric care (scale of 1–10, where 10 = best)l
 Rating of overall quality of child’s well-child visit 8.0 ± 0.3 8.9 ± 0.1 .01
 Rating of child’s PCP 8.4 ± 0.5 9.2 ± 0.1 .16
 Rating of child’s acute care 8.5 ± 0.4 9.1 ± 0.1 .17
 Quality rating of child’s specialty care 6.8 ± 1.7 8.8 ± 0.3 .30
Parental satisfaction with care
 Doctor never/sometimes takes time to understand child’s specific needs 14 (34%) 28 (14%) .01
 Doctor never/sometimes respects you are expert on your child 12 (29%) 27 (14%) .02
 Doctor never/sometimes asks how you are feeling as parent 23 (56%) 91 (46%) .26
 Doctor never/sometimes understands how your prefer to raise child 17 (41%) 56 (29%) .10
 Doctor did not spend enough time with child 4 (10%) 19 (10%) .99
 Did not ask all questions I wanted to ask 5 (13%) 10 (5%) .08
 Would not recommend child’s healthcare provider to friends 10 (24%) 15 (8%) <.0001
Satisfaction with process of obtaining insurance    <.0001
 Very satisfied 4 (10%) 93 (48%)  
 Satisfied 7 (18%) 71 (37%)  
 Uncertain 11 (28%) 18 (9%)  
 Dissatisfied 8 (20%) 7 (4%)  
 Very dissatisfied 10 (25%) 5 (3%)  
Parental out-of-pocket costs of pediatric carek
 Mean out-of-pocket cost per doctor visit $70 ± 15 $29 ± 15 <.0001
 Mean out-of-pocket cost per preventive-care visit $67 ± 29 $9 ± 3 .01
 Mean out-of-pocket cost per sick visit $86 ± 18 $16 ± 4 <.0001
 Mean out-of-pocket cost per ED visit $146 ± 75 $77 ± 63 .01
 Mean out-of-pocket cost per hospital stay $25 ± 25 $0 ± 0 .33
Parental-reported financial burden
 Need additional income to cover child’s medical expenses 12 (29%) 10 (5%) .01
 Child’s health caused financial problem for family 12 (29%) 13 (7%) .01
 Family cut down on work hours to obtain healthcare for child 3 (7%) 12 (6%) .81
 Stopped working because of child’s health 3 (7%) 5 (3%) .12
Missed school and work days due to child’s healthk
 Missed school days in past year 2.1 ± 0.4 2.5 ± 0.3 .34
 Missed work days in past year due to child’s illness 0.5 ± 0.2 0.7 ± 0.2 .41
 Wage loss in past year due to missed work days $1237 ± 1038 $490 ± 229 .50
 Other costs related to taking care of sick child $6030 ± 5970 $622 ± 342 .02
  1. aPlus-minus values are means ±SD, except where noted. PCP denotes primary-care provider, and PedsQL denotes Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales
  2. bBy caregiver report
  3. cAmong the N = 48 who reported that their child needed immediate care from the PCP
  4. dAmong the N = 23 who reported that they needed after-hours telephone help or advice and had one-year follow-up data
  5. eAmong the N = 170 who reported that their child needed preventive care
  6. fAmong the N = 129 who reported that their child needed acute care
  7. gAmong the N = 53 who reported that their child needed specialty care
  8. hAmong the N = 192 who reported that their child needed dental care
  9. iAmong the N = 132 who reported that their child needed prescription medications
  10. jAmong the N = 61 who reported that their child needed medical supplies or equipment
  11. kPlus-minus values are means ±SE
  12. lBy caregiver report, using a scale of 0–10, in which 0 = worst possible rating and 10 = best possible rating