Continuity of public insurance coverage: a systematic review of the literature.

TitleContinuity of public insurance coverage: a systematic review of the literature.
Publication TypeJournal Article
Year of Publication2014
AuthorsGuevara JP, Moon J, Hines EM, Fremont E, Wong A, Forrest CB, Silber JH, Pati S
JournalMed Care Res Rev
Date Published2014 Apr
KeywordsAdolescent, Child, Child, Preschool, Continuity of Patient Care, Humans, Infant, Infant, Newborn, Insurance Coverage, Insurance, Health, United States, Young Adult

Publicly financed insurance programs are tasked with maintaining coverage for eligible children, but published measures to assess coverage have not been evaluated. Therefore, we sought to identify and categorize measures of health insurance continuity for children and adolescents. We conducted a systematic review of Medline and HealthStar databases, review of reference lists of eligible articles, and contact with experts. We categorized measures into 8 domains based on a conceptual framework. We identified 147 measures from 84 eligible articles. Most measures evaluated the following domains: always insured (41%), repeatedly uninsured (36%), and transition out of coverage (29%), while fewer assessed single gap in coverage, always uninsured, transition into coverage, change in coverage, and eligibility. Only 18% of measures assessed associations between continuity of coverage and child and adolescent health outcomes. These results suggest that a number of measures of continuity of coverage exist, but few measures have assessed impact on outcomes.

Alternate JournalMed Care Res Rev
PubMed ID24227811
Grant ListU18HS020508 / HS / AHRQ HHS / United States