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Unmet needs for vision care among children with gaps in health insurance coverage
Mufida Muhammad1, Dmitry Tumin1
1Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, North Carolina.
Insights
Gaps in health insurance significantly increase unmet vision care needs in children. Children with coverage gaps were nearly 19 times more likely to have unmet vision care needs compared to those with continuous coverage.
Area of Science:
- Public Health
- Ophthalmology
- Health Services Research
Background:
- Access to vision care is crucial for identifying and managing vision impairments.
- Lack of health insurance coverage can be a barrier to children receiving necessary vision services, leading to unmet needs.
Purpose of the Study:
- To investigate the association between health insurance coverage gaps and unmet vision care needs in US children.
- To quantify the increased odds of unmet vision care needs among children experiencing insurance instability.
Main Methods:
- Utilized deidentified data from the National Survey of Children's Health (2016-2019).
- Analyzed data from 106,876 children aged 3-17 years.
- Primary outcome: caregiver-reported unmet vision care needs in the preceding 12 months.
Main Results:
- 3.8% of US children experienced a gap in health insurance coverage.
- Children with coverage gaps had 18.7 times higher odds of unmet vision care needs.
- Children with no insurance for the entire year had 9.5 times higher odds of unmet vision care needs.
Conclusions:
- Children with intermittent health insurance coverage face the highest risk of unmet vision care needs.
- Insurance gaps are a significant predictor of delayed or missed vision care for children.
- Policy interventions addressing insurance continuity may improve vision health outcomes for children.
Background:
Access to vision care is essential for diagnosing and treating vision impairments. Gaps in health insurance coverage may prevent children from receiving vision care and lead to unmet needs for vision services.
Methods:
This study used deidentified data on children 3-17 years of age from the 2016-2019 National Survey of Children's Health. The primary outcome was caregiver-reported unmet needs for vision care in the previous 12 months.
Results:
Based on a sample of 106,876 children, 3.8% of US children had a recent gap in coverage, and 5.0% lacked insurance in the entire year leading up to the survey. The estimated population prevalence of caregiver-reported unmet needs for vision care was 0.7%. However, children with gaps in coverage had almost 19-fold higher odds of having caregiver-reported unmet vision care needs (OR = 18.7; 95% CI, 11.5-30.2; P < 0.001), and children with a complete lack of coverage also had a ninefold higher odds of caregiver-reported unmet vision care needs (OR = 9.5; 95% CI, 5.5-16.4; P < 0.001), compared to children with year-round private coverage. In the 2018-2019 data, results were similar when analyzing completion of routine vision testing within the past 12 months.
Conclusions:
Children with gaps in coverage had the highest likelihood of caregiver-reported unmet vision care needs compared with children with year-round coverage or children with year-round lack of coverage.
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