Little attention has focused on barriers to coverage among the privately insured children, although, a large portion of the American children are covered under private insurance. Especially in an era of deteriorating private coverage, it has become very important to investigate whether privately insured chronically ill children are at risk for treatment. Our study aims to fill this gap using a unique longitudinal dataset that contains information on a large group of privately insured children and their families. In this project, we will take a first step in investigating how parents respond to private insurance cost sharing regarding health services use of their children by studying the impact of prescription drug coverage on outcomes by the chronically ill children. The primary specific aim of the proposed research is to determine how changes in prescription drug cost sharing affect adherence to prescription drug therapy for various chronic conditions among the privately insured chronically ill children. As a secondary aim, we propose to identify the effect of prescription drug cost sharing on inpatient and outpatient spending among the chronically ill children. In both aims, we will control for other health plan characteristics, child's own characteristics, co-morbid conditions, general family characteristics, and the out-of-pocket burden of other family members.

Public Health Relevance

Little attention has focused on barriers to coverage among the privately insured children, although, a large portion of the American children are covered under private insurance. Especially in an era of deteriorating private coverage, it has become very important to investigate whether privately insured chronically ill children are at risk for treatment. Our study aims to fill this gap using a unique longitudinal dataset that contains information on a large group of privately insured children and their families. We will take a first step in investigating how parents respond to private insurance cost sharing regarding health services use of their children by studying the impact of prescription drug coverage on outcomes by the chronically ill children.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Small Research Grants (R03)
Project #
1R03HD058203-01A1
Application #
7587773
Study Section
Pediatrics Subcommittee (CHHD)
Program Officer
Spittel, Michael
Project Start
2009-06-01
Project End
2011-05-31
Budget Start
2009-06-01
Budget End
2010-05-31
Support Year
1
Fiscal Year
2009
Total Cost
$89,875
Indirect Cost
Name
Rand Corporation
Department
Type
DUNS #
006914071
City
Santa Monica
State
CA
Country
United States
Zip Code
90401
Karaca-Mandic, Pinar; Jena, Anupam B; Joyce, Geoffrey F et al. (2012) Out-of-pocket medication costs and use of medications and health care services among children with asthma. JAMA 307:1284-91