191 - Childhood Underinsurance During The COVID-19 Pandemic

Poster Number: 191
Publication Number: 191.319

John Pascoe, Wright State University Boonshoft School of Medicine, Dayton, OH, United States; Brooklynne Dilley, Wright State University Boonshoft School of Medicine, Dayton, OH, United States; Samantha A. Roberts, Wright State University Boonshoft School of Medicine, Beavercreek, OH, United States; Greg Eberhart, Cornerstone Pediatrics, Miamisburg, OH, United States; Adrienne Stolfi, Wright State University, Dayton, OH, United States

Background: Health insurance makes an important contribution to children's health. Earlier work has found no effect of the Affordable Care Act on children's underinsurance status in southwestern Ohio. This study examines childhood underinsurance in southwestern Ohio during the COVID-19 pandemic.

Objective: To document the prevalence and correlates of children's underinsurance during the COVID-19 pandemic.

Design/Methods: This is a cross sectional study of a convenience sample of children being seen in primary care practices within the Southwestern Ohio Ambulatory Research Network (SOAR-Net). Study parents were recruited in the waiting rooms of participating SOAR-Net practices from June through November 2021. Respondents completed the Medical Expenses of Children Survey that has been employed in similar research since 2009. Index children were considered underinsured if their parents responded "yes" to at least one of six questions regarding inability to pay for a pediatrician's recommendation despite the child having health insurance. Children were eligible between the ages of 6 months and 18 years. This analysis focused solely on index children's parents.

Results: 394 caregivers were approached in waiting rooms of SOAR-Net practices. The response rate was 83%. This analysis focussed on the 300 parents who completed the survey. 83% of respondents were the index child's mother, more than three quarters (78%) were white, and 71% were married. About 43% had a college degree, and over 57% of respondents reported annual income of at least $50,000. children's mean age (Nf293) was 8.9 (5.3) years. 14% of index children were underinsured. This is a similar prevalence compared to earlier studies using identical survey questions. Almost half (46%) of parents raising underinsured children reported that it was harder to access care for their child compared to 3 years ago, while only 6% of parents raising adequately insured children reported it was harder (p < 0.001). COVID-19 was more likely to have a negative effect on underinsured children's mental health (60%) compared to adequately insured children (33%, p=0.001).Conclusion(s): About one in six children remain underinsured in southwestern Ohio. Almost one half of parents of underinsured children report it is harder to access care for their child in 2021 compared to three years earlier, and the majority of parents of underinsured children report the pandemic has had a negative effect on their children's mental health. Further research should continue to examine factors related to underinsurance as many families struggle to raise their children during the COVID-19 pandemic.