Uninsured Children With Asthma Receive ‘Poorer’ Quality of Care than Insured Children, Study Says

Uninsured children with asthma receive a "consistently poorer quality of care than" children with insurance, as do those on Medicaid, a study in the September issue of the journal Ambulatory Pediatrics states. Children in managed care plans received a similar quality of care and had "no worse outcomes" than children with indemnity health plans, but children in MCOs had a "greater severity of acute asthma." Researchers studied 965 children with acute asthma who visited 36 emergency departments, comparing quality of care prior to ED visit, severity of illness and short term outcomes. The children studied were either uninsured or enrolled in managed care or indemnity plans or Medicaid. Children in managed care or indemnity plans were similar in seven quality measures, the study found. However, children enrolled in Medicaid and those without insurance ranked significantly lower in several indicators, including percentage with a primary care provider; percentage using an ED for a usual site of asthma care; percentage with more than one "acute office" visit in the last year; and percentage visiting their primary care provider within the week before the ED visit (Ferris et al., "Insurance and Quality of Care for Children with Acute Asthma," September 2001).