TABLE 2

Study Outcomes at 1-Year Follow-Up and for Long-Term Insurance Coverage

OutcomeaControl Group (n = 114)PM Group (n = 123)P
Primary outcome: child obtained health insurance, n (%)78 (68)117 (95)<.001
 Adjusted relative risk (95% CI)bReferent1.30 (1.21–1.32)<.001
 Adjusted odds ratio (95% CI)bReferent2.93 (2.14–4.00)<.001
Median number of days to obtaining insurance (IQR)140 (61–236)62 (33–112)<.001
Sporadic insurance coverage, n (%)c39 (34)32 (26).21
Renewed insurance, n (%)d42 (60)80 (85)<.001
Health-insurance coverage 1 y after cessation of PM intervention, n (%)e62 (76)73 (95)<.001
Health-insurance coverage 2 y after cessation of PM intervention, n (%)f32 (76)39 (100)<.001
Parental satisfaction with process of trying to obtain health insurance for child, n (%)<.001
 Very satisfied28 (25)69 (57)
 Satisfied45 (40)33 (27)
 Uncertain17 (15)12 (10)
 Dissatisfied10 (9)5 (4)
 Very dissatisfied13 (12)2 (2)
Health status and health-related quality of life
 Health status not excellent/very good, n (%)g41 (36)31 (25).07
 PedsQL total score94.3 ± 9.394.0 ± 9.7.84
Access to health care, n (%)
 Child has no PCP45 (40)19 (16)<.001
 Child has no usual source of preventive care8 (7)1 (1).013
 Child has no usual source of sick care8 (7)3 (2).09
 Different source of sick care and preventive care31 (27)19 (16).03
 Never/sometimes gets immediate care from PCP5 (19)0 (0).03
 Has problems getting care from specialistsh6 (46)2 (11).03
 Delayed or did not get needed health care in past year29 (25)16 (13).02
 Did not receive all needed preventive care in past year16 (22)4 (4)<.001
 Did not receive all needed acute care in past year5 (20)1 (3).04
 Did not receive all needed dental care in past year27 (31)18 (18).03
 Did not receive all needed prescription medications in past year2 (4)1 (2).42
Use of health services and out-of-pocket costsi
 Doctor visits in past year2.6 ± 0.32.9 ± 0.3.24
 Out-of-pocket cost per doctor visit$37.24 ± 7.5$32.87 ± 24.0<.001
 Preventive-care visits in past year0.9 ± 0.11.3 ± 0.1.01
 Out-of-pocket cost per preventive-care visit$27.49 ± 9.0$4.63 ± 1.5.09
 Sick visits in past year1.6 ± 0.31.4 ± 0.2.64
 Out-of-pocket cost per sick visit$42.74 ± 9.4$9.38 ± 3.1<.001
 ED visits in past year0.34 ± 0.10.33 ± 0.1.59
 Out-of-pocket cost per ED visit$94.04 ± 92.5$80.74 ± 33.0.22
 Hospitalizations in past year0.03 ± 0.020.02 ± 0.03.35
 Out-of-pocket cost per hospitalization$25.00 ± 22.5$0 ± 0.25
Quality of carej
 Quality rating of child’s well-child care8.6 ± 1.58.9 ± 1.4.03
 Quality rating of child’s PCP9.0 ± 1.79.2 ± 1.3.55
 Quality rating of child’s acute care8.8 ± 1.69.2 ± 1.2.07
 Quality rating of child’s specialty care8.1 ± 2.58.8 ± 1.7.22
Parental satisfaction with care, n (%)
 Doctor never/sometimes takes time to understand child’s specific needs27 (24)15 (12).02
 Doctor never/sometimes respects you are expert on your child26 (23)13 (11).01
 Doctor never/sometimes understands how you prefer to raise child42 (37)31 (25).04
 Doctor did not spend enough time with child12 (11)11 (9).68
 Did not ask all questions I wanted to ask9 (8)6 (5).34
 Would not recommend child’s health care provider to friends18 (16)7 (6).01
Family financial burden and missed school and work days due to child’s illness, n (%)
 Need additional income to cover child’s medical expenses15 (13)7 (6).04
 Child’s health caused financial problems for family16 (14)9 (7).09
 Family cut down on work hours to obtain health care for child9 (8)6 (5).34
 Median caregiver wage loss due to missed work days to care for sick child (IQR)$200 ($135–300)$240 ($125–408).18
 Median other costs related to taking care of sick child (IQR)$324 ($30–600)$150 ($80–1344).58
 Median number of missed school days in past year (IQR)2.0 (0–3)2.0 (0–4).83
 Median number of missed work days in past year due to child’s illness (IQR)0 (0–0)0 (0–0).65
  • IQR, interquartile range; PedsQL, Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales.

  • combined income below the federal poverty threshold.

  • CHIP in Texas require annual renewal).

  • control group and 77 in the PM group could be evaluated and were assessed for health-insurance coverage.

  • the control group and 39 in the PM group could be evaluated and were assessed for health-insurance coverage.

  • a Plus-minus values are means ± SD, except where indicated.

  • b Adjusted for child gender and age, citizenship and employment status of primary caregiver, and an annual

  • c Child was insured but then lost health insurance at some point during the 1-y follow-up interval.

  • d Among children covered by Medicaid who were required to renew coverage after 6 mo (children covered by

  • e At the 2-y follow-up assessment, 1 y after cessation of the PM intervention, when a total of 82 children in the

  • f At the 3-y follow-up assessment, 2 y after cessation of the PM intervention, when a total of 42 children in

  • g By caregiver report.

  • h Among those who reported that their child needed specialty care.

  • i Plus-minus values are means ± SE.

  • j By caregiver report, using a scale of 0 to 10, in which 0 = worst possible rating and 10 = best possible rating.