The impact of health insurance status on adolescents'utilization of school-based clinic services : implications for health care reform.
1) To examine variations among students with different health insurance coverage in their use of school-based clinics (SBCs), reasons for not receiving health care when needed, and reasons for using or not using SBCs, and 2) to determine if insurance status is a significant factor in predicting SBC use, after controlling for demographic variables and health status.
Confidential questionnaires were administered to 2,860 adolescents attending 3 urban high schools with on-site SBCs.
Chi-square and multiple logistic regression analyses were used to assess differences among insurance groups in patterns of SBC use and reasons for clinic use/nonuse.
Students with private insurance or HMO coverage had the highest rates of SBC utilization (67% & 66%) and students without health insurance and with Medicaid had the lowest (57% & 59%) (p<0.01).
While there was no difference among adolescents according to insurance group membership in their use of SBC medical services, a significantly higher proportion of students with Medicaid coverage used SBC mental health services.
Students without health insurance were less likely to receive health care from any source when it was needed.
After controlling for demographic variables and health status, no insurance factors remained significant.
SBC users represent a variety of insurance groups.
Mots-clés Pascal : Prévention, Programme sanitaire, Milieu scolaire, Utilisation, Service santé, Assurance maladie, Etats Unis, Adolescent, Amérique du Nord, Amérique, Homme
Mots-clés Pascal anglais : Prevention, Sanitary program, School environment, Use, Health service, Health insurance, United States, Adolescent, North America, America, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0179041
Code Inist : 002B30A03B. Création : 09/06/1995.