Chartbook on Healthy Living

Maternal and Child Health Care Measures

• Access:
  • Periods of uninsurance.
• Effectiveness:
  • Prenatal care.
  • Receipt of recommended immunizations by young children.
  • Children's vision screening.
  • Well-child visits in the last year.
  • Receipt of meningococcal vaccine by adolescents.
  • Receipt of human papillomavirus (HPV) vaccination by adolescents.
• Person-Centered Care:
  • Children who had a doctor's office or clinic visit in the last 12 months who reported poor communication with health providers.
• Patient Safety:
  • Birth trauma—injury to neonates.
• Care Coordination:
  • Children and adolescents whose health provider usually asks about prescription medications and treatments from other doctors.
  • Emergency department (ED) visits with a principal diagnosis related to mental health, alcohol, or substance abuse.
  • ED visits for asthma.

Access: Children and Adolescents With Periods of Uninsurance

• Coverage gaps ("uninsurance") are a significant factor in children's access to and use of care, as well as their health outcomes.^1-3
• Resources through the Children's Health Insurance Program Reauthorization Act (CHIPRA) are designed to increase Medicaid/CHIP enrollment:
  • Outreach programs.
  • Simplified enrollment strategies.⁴
• Coverage gaps are still found for as many as 40 percent of new CHIP enrollees⁵ despite changes in State enrollment, renewal, and outreach processes.

Children and Adolescents Without Insurance

Children and adolescents ages 0-17 years with any period of uninsurance during the year, by insurance, 2002-2012, and by race/ethnicity and income, 2012

Left Chart:

Right Chart:

Key: CHIP = Children's Health Insurance Program.
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2012.
Note: White and Black are non-Hispanic. Hispanic includes all races.

• Trends:
  • The overall percentage of children and adolescents ages 0-17 years with any period of uninsurance during the year declined from 19.1% in 2002 to 14.3% in 2012.
  • Among children and adolescents with any Medicaid or CHIP insurance, the percentage with any period of uninsurance during the year declined from 20.0% in 2002 to 12.9% in 2012.
  • Among children and adolescents with other insurance alone, the percentage with any period of uninsurance during the year declined to a statistically nonsignificant degree, falling from 8.5% in 2002 to 7.2% in 2012.
• Groups With Disparities:
  • In 2012, White children (11.6%) were less likely to have a period of uninsurance than both Blacks (15.9%) and Hispanics (19.6%).
  • In 2012, children in families with high incomes (i.e., those >400% of the Federal poverty level) were less likely than children in every other income category (poor, low income, middle income) to have experienced a period of uninsurance (6.7% versus 13.9%, 19.3%, and 17.5%, respectively).

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