View Research by Author - Moira Inkelas

Publications

Children enrolling for a medical reason in Healthy Kids reported a range of common conditions including allergies, anemia, asthma, cough/cold, stomach problems, and ear/eye infection as their reason for enrollment. A large portion (67%) of parents report enrolling because the child needed prescription medication the family could not afford. Enrollment was associated with improved access to health care and lower out-of-pocket costs. However, families of children enrolled for a medical reason faced persistent barriers in accessing sub-specialty care and demonstrated higher use of emergency department services compared to those not enrolled for a medical reason. Los Angeles, CA: University of California – Los Angeles. May 2009.

Enrollment in Healthy Kids is associated with some improvement in eliciting parent concerns and providing health education, but participation did not increase information for parents about their concerns or affect the proportion of children for whom parents have some type of concern regarding learning, development or behavior. The lack of improvement in these areas despite enrollment in a medical insurance program likely results from larger systems-level barriers to adequate developmental assessment/monitoring and anticipatory guidance within primary care. Findings suggest these barriers such as time, competing demands, and incentives in primary care are not reduced simply by enrollment in health insurance. Los Angeles: University of California at Los Angeles. September 2009.

This brief examines rates of ED visits associated with ACSC diagnoses in the first few years of Healthy Kids (2005-06). Low rates of ED use for ACSC suggest that high use is not a major problem among program enrollees. The rate of ACSCs as a proportion of ED visits also did not decline over the study period, suggesting that while the Healthy Kids evaluation shows an impact upon perceived access to care and affiliation with a primary care provider, the expansion may not have a significant impact upon relatively rare events, such as pediatric hospital stays and ED visits.

The Los Angeles Healthy Kids program was created in 2003 to provide health insurance to uninsured children ages 0–5 years in families with household income below 300 percent of the federal poverty level (FPL) who are ineligible for SCHIP or Medicaid. A quality of care survey sampled parents of 538 children ages 12–72 months enrolled in the program for at least one year. Results show that quality of preventive care for children in Healthy Kids has similar patterns as care for children in low-income households, both in California and nationally. Content of preventive care is well below American Academy of Pediatrics (AAP) recommendations, although it is consistent with statewide and national levels of care.

This report summarizes the findings from a survey of parents of Healthy Kids enrollees aged 1 to 5 in Los Angeles County. The Los Angeles Healthy Kids program was implemented in July 2003 and provides insurance coverage to low income, uninsured children, who are ineligible for Medi-Cal or Healthy Families. This report is one of a series evaluating the Healthy Kids program in L.A. and analyses the demographic characteristics of enrolled children, their health status, health care access and use experiences, parental impressions of the enrollment and renewal processes, among other topics. One year from now, a second survey report will provide results from the longitudinal follow-up with the same parents and will assess the impact of the Healthy Kids program in L.A.

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