CANDIDATE: Dr. DeVoe is proposing to study how loss of parental health insurance affects children's access to health care services. She will continue to build upon her solid health services research foundation by working with expert mentors who support her goal of becoming an independent investigator. RESEARCH FOCUS: Despite programs such as Medicaid and the State Children's Health Insurance Program (SCHIP), many children in the U.S. do not currently have health insurance. It has been shown that expanding parental coverage leads to improved access to health insurance for children. LESS IS KNOWN ABOUT HOW TERMINATION OF PARENTAL COVERAGE AFFECTS CHILDREN. The Oregon Health Plan (OHP), an innovative Medicaid expansion program, has recently implemented cost sharing measures that have led to the loss of coverage for thousands of Oregon parents. Although these OHP policies were aimed at adults, there may be an indirect affect on children. This proposal expands on current research and has been designed to focus on how parental insurance loss is affecting children's access to care. TRAINING GOALS: Dr. DeVoe's training goals include: (1) broadening her knowledge and experience in large database management and advanced statistical analysis, with a focus on identifying variables to link across state and national datasets and the use of propensity scores and longitudinal analytical techniques; and (2) expanding her skills in conducting policy relevant studies and disseminating findings more effectively, with formal training in the use of geographic information system (CIS) software. METHODS: (1) Cross-sectional analysis and GIS spatial analysis of the national Medical Expenditure Panel Survey and a survey of Oregon parents. (2) Longitudinal analysis of three waves of survey data from an ongoing statewide prospective cohort study. OUTCOMES: We will measure how parental loss of insurance and other barriers to children's insurance coverage are associated with differences in children's health insurance enrollment rates, access to health care services, patterns of health services utilization, and reported health status.

Public Health Relevance

This analysis will provide valuable information for states attempting to expand children's health insurance coverage and looking for ways to minimize barriers in order to keep children insured.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08HS016181-02
Application #
7223474
Study Section
HSR Health Care Research Training SS (HCRT)
Program Officer
Anderson, Kay
Project Start
2006-07-01
Project End
2011-06-30
Budget Start
2007-07-01
Budget End
2008-06-30
Support Year
2
Fiscal Year
2007
Total Cost
Indirect Cost
Name
Oregon Health and Science University
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
096997515
City
Portland
State
OR
Country
United States
Zip Code
97239
DeVoe, J E; Stenger, R (2013) Aligning provider incentives to improve primary healthcare delivery in the United States. OA Fam Med 1:7
Yamauchi, Melissa; Carlson, Matthew J; Wright, Bill J et al. (2013) Does health insurance continuity among low-income adults impact their children's insurance coverage? Matern Child Health J 17:248-55
Devoe, Jennifer E; Gold, Rachel (2013) Community of solution for the U.S. health care system: lessons from the U.S. educational system. J Am Board Fam Med 26:323-6
Angier, Heather; DeVoe, Jennifer E; Tillotson, Carrie et al. (2013) Changes in health insurance for US children and their parents: comparing 2003 to 2008. Fam Med 45:26-32
Pandhi, Nancy; DeVoe, Jennifer E; Schumacher, Jessica R et al. (2012) Number of first-contact access components required to improve preventive service receipt in primary care homes. J Gen Intern Med 27:677-84
Devoe, Jennifer E; Tillotson, Carrie J; Wallace, Lorraine S et al. (2012) The effects of health insurance and a usual source of care on a child's receipt of health care. J Pediatr Health Care 26:e25-35
Faricy, Lauren; Page, Tanya; Ronick, Mischa et al. (2012) Patterns of empiric treatment of Chlamydia trachomatis infections in an underserved population. Fam Med 44:408-15
DeVoe, Jennifer E; Tillotson, Carrie J; Wallace, Lorraine S et al. (2012) Is health insurance enough? A usual source of care may be more important to ensure a child receives preventive health counseling. Matern Child Health J 16:306-15
DeVoe, Jennifer E; Westfall, Nicholas; Crocker, Stephanie et al. (2012) Why do some eligible families forego public insurance for their children? A qualitative analysis. Fam Med 44:39-46
Gold, Rachel; DeVoe, Jennifer E; McIntire, Patti J et al. (2012) Receipt of diabetes preventive care among safety net patients associated with differing levels of insurance coverage. J Am Board Fam Med 25:42-9

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