Harvard researchers report on impact of health insurance in youths' disease management
MONDAY, April 22, 2013 (HealthDay News) -- The loss of health insurance is the main reason asthma care for young people deteriorates after age 18, according to a new study.
Certain social factors -- such as leaving school and no longer having adult supervision -- also contribute to the decline in care, according to Harvard Medical School researchers.
"This study suggests that expanding insurance coverage will help many young adults with asthma receive the care they need," study leader Kao-Ping Chua, a staff physician in the division of emergency medicine at Boston Children's Hospital, said in a Harvard news release. "But it also points to the importance of addressing other socially mediated factors in this population."
"Aside from the lack of financial protection, uninsurance poses fewer health risks to young adults than for older adults because they are generally healthy," study senior author J. Michael McWilliams, an assistant professor of health care policy and medicine at Harvard Medical School, said in the news release.
"But for young people with asthma -- or other conditions amenable to medical care -- it's important to understand and address the barriers to care," he added.
The researchers looked at data from nearly 2,500 asthma patients, aged 14 to 25, in order to determine if they had a regular care provider, if they visited that provider at least once a year, if they used asthma medications and if they made emergency-room visits.
Patients under age 18 were more likely to use primary care and asthma medications, while those over 18 were more likely to make emergency-room visits and have problems getting care and medications due to cost.
The loss of health insurance explained 32 percent of the decline in the use of primary care by patients over age 18 and between 47 percent and 61 percent of the increase in their cost-related problems getting care and medications, according to the study, which was published recently in the journal Pediatrics.
Under the federal Affordable Care Act, young adults whose parents have private insurance will be eligible to continue receiving coverage on their parents' policies until they are 26. But, the researchers said, since the U.S. Supreme Court ruled that states do not have to extend similar coverage to people on Medicaid, low-income young adults will be left out.
Health insurance, however, is not the only problem, they added.
"Young people with asthma need to work with their care providers to create transition plans from pediatric to adult care that take into account their medical and social history," Chua said.
The U.S. National Heart, Lung, and Blood Institute has more about asthma (http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/ ).
SOURCE: Harvard Medical School, news release, April 22, 2013