Studies: Insurance access, medical home benefit undocumented children

Undocumented children who have access to health insurance are healthier and more engaged in school than those without insurance, according to researchers at the Keck School of Medicine of the University of Southern California (USC) in Los Angeles. Findings from the data were published in two separate studies.

According to lead author Gregory D. Stevens, PhD, assistant professor of family medicine at the Keck School, the data are the first to show a direct health benefit to children from a medical home. "We found that there is a strong association between high-quality medical care and health improvement and school engagement,” he stated.

A family-centered medical home is an approach to providing patients with comprehensive primary care.

Authors Stevens and Michael R. Cousineau, DrPH, associate professor of research in the Keck School's department of family medicine, evaluated the efficacy of Healthy Kids, a county-led program that provides affordable health insurance for children of low-income families who don't qualify for state insurance programs such as Medi-Cal and Healthy Families. At the time of data collection in 2009, Healthy Kids was offered in 24 of 58 California counties, providing about 70,700 children statewide with comprehensive medical, dental and vision coverage.

The researchers surveyed 4,011 children from 21 of the 24 Healthy Kids programs. The sample consisted mostly of Latino children in low-income, undocumented and predominantly Spanish-speaking families. Nearly 95 percent of the 2,230 families cooperated and the sample was divided into three groups: established enrollees (in the program for one year or more), new enrollees (less than one year) and children on a wait list.

In a study that appeared in the September issue of Medical Care, the researchers found that those enrolled in Healthy Kids were more likely to have a regular source of healthcare and reported better medical home experiences than the children on a wait list. Children who were enrolled in the program for more than one year reported the best medical home experiences among the three groups.

In a separate study published online by Health Services Research, the researchers found that children who reported better medical home experiences missed fewer days at school and performed better overall in math and reading. For example, for every one-point increase in the medical home's total score, the odds of missing fewer than three school days due to illness or injury in the past school year increased by 12 percent. Among the measured indicators of medical home quality, access was most strongly associated with improved health and school engagement.

"It supports the argument to keep providing affordable health insurance for undocumented kids," concluded Stevens.

The research was funded by the California Endowment, a private health foundation, and First 5 California, a tobacco tax-funded state agency focused on providing children's services.

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