Published online June 1, 2007
PEDIATRICS Vol. 119 No. 6 June 2007, pp. 1175-1180 (doi:10.1542/peds.2006-1881)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (1)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Callahan, S. T.
Right arrow Articles by Cooper, W. O.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Callahan, S. T.
Right arrow Articles by Cooper, W. O.
Related Collections
Right arrow Office Practice

ARTICLE

Continuity of Health Insurance Coverage Among Young Adults With Disabilities

S. Todd Callahan, MD, MPHa and William O. Cooper, MD, MPHb

a Divisions of Adolescent Medicine
b General Pediatrics, Child and Adolescent Health Research Unit, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee

OBJECTIVES. Although considered critical to facilitate the successful transition from pediatric to adult health care, the continuity of insurance coverage for young adults with disabilities as they make the transition to adulthood has not been well characterized. The purpose of this work was to compare the continuity of insurance coverage reported by a nationally representative sample of young adults 16 to 25 years old with and without disabilities during a consecutive 36-month period.

METHODS. We performed secondary analysis of data from the 2001 Survey of Income Program and Participation. Data for the survey were collected at 4-month intervals from February 2001 through January 2004 for 5170 young adults. Subjects with disabilities were those who reported limitations in activities of daily living or work, used assistive devices, and/or had learning disabilities, mental retardation, or other mental disorders. The primary outcome was uninsurance defined for each study month in which there was no coverage by private, public, or military programs. We present bivariate analyses of the months of uninsurance according to disability status using longitudinal weights and design-effect adjustments to account for the complex sample design.

RESULTS. The sample consisted of 599 subjects with and 4571 without reported disabilities, representing 3970000 and 30800000 young adults in the United States, respectively. At study entry, 22% of the young adults with disabilities were uninsured. During the 36-month follow-up period, 56% of the young adults with disability reported gaps in insurance coverage with a mean of 15 months of uninsurance. The proportion of uninsured subjects did not significantly differ by disability status.

CONCLUSIONS. The majority of young adults with disabilities reported gaps in insurance coverage, and many were uninsured for a substantial portion of the study period. As an increasing number of children with special health care needs make the transition to adulthood, improving the continuity of health insurance coverage for this population warrants specific attention.

Key Words: insurance • transition to adulthood • disabilities • chronic illness/condition

Abbreviations: SIPP—Survey of Income Program and Participation • ADL—activities of daily living • IADL—instrumental activities of daily living

Accepted Jan 30, 2007.