Objective. To explore recent trends in the health insurance status of adolescents hospitalized in New York State and the extent to which they reflect changes in the health insurance status of adolescents in the broader population. To evaluate the potential public health implications of these trends and their consequences for the future health status of these groups.
Methods. The author analyzed data from eleven years of New York State SPARCs hospital discharge data, in order to identify trends in type of insurance and rates of self-pay, among the adolescent patient population. Private and public hospitals are compared.
Results. While rates of Medicaid coverage among hospitalized adolescents increased in New York State until 1997, following a relaxing of enrollment criteria for children during the mid 1980s, they declined steadily thereafter. In New York City, the recent decline has been even more dramatic and was accompanied by a rise in the rate of self-pay patients.
Conclusions. The increased proportion of uninsured adolescents is primarily due to declining rates of private insurance among older adolescents who are ineligible for CHP or special Medicaid criteria. Public hospitals are carrying an increasing share of the costs of the uninsured. Medicaid decline under welfare reform coupled with the recent slowing of the economy is likely to cause a further increase in rates of self-pay among hospitalized adolescent populations. The result will be a sacrifice in terms of the quality of care or a refusal of services to those unable to pay.
Learning Objectives: To explore recent trends in the health insurance status of adolescents hospitalized in New York State and the extent to which they reflect changes in the health insurance status of adolescents in the broader population. To evaluate the potential public health implications of these trends and their consequences for the future health status of these groups.
Keywords: Health Insurance,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.