WIP 117 - Impact of Insurance Discontinuity on Access to Care in U.S. Children in the Peri-Pandemic Period

Poster Number: WIP 117
Publication Number: WIP 117.882

Background: Lack of or discontinuous insurance coverage is associated with poor health outcomes and access to care. However, there is minimal recent literature examining the relationship between insurance coverage, particularly continuous coverage, and emergency department (ED) visits in children. The impact of the Medicaid continuous coverage requirement during the COVID-19 pandemic emergency (ended March 31, 2023) on access to care and ED visits has not been fully described.

Objective: We aim to describe contemporary patterns in insurance continuity and access to care in a nationally representative cohort of children, including the relationship between these outcomes and ED visits.

Design/Methods: Using de-identified data from the publicly available 2019, 2021, and 2022 National Health Interview Survey (NHIS), we will estimate insurance coverage trends among children, ages 0-17 years, with and without ED visits, categorized by key child and family characteristics, including family income, age, race/ethnicity, and region. We classify coverage trends as continuous coverage, no coverage, or discontinuous coverage, within the prior 12 months. Descriptive tables will be developed, stratified by the above years, including insurance coverage, access to care, and ED visits. Parametric and non-parametric statistical tests will be used to assess differences and trends over time. Multivariate regression models will be used to assess the independent associations between these outcomes (access to care and insurance coverage) and relevant patient characteristics, including the number of ED visits. The R statistical package will be used for all regression models to allow application of weights within NHIS data. The study was deemed exempt from our local institutional review board and preliminary data analysis has been performed for 2019 and 2021 in October 2023. Data analysis for 2022 will be added by January of 2024, along with refinement of regression models, interpretation of study results, and drafting of a manuscript by March 2024.