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Association between insurance variability and early lung function in children with cystic fibrosis.

Authors :
Dickinson KM
Psoter KJ
Riekert KA
Collaco JM
Source :
Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society [J Cyst Fibros] 2022 Jan; Vol. 21 (1), pp. 104-110. Date of Electronic Publication: 2021 Jun 24.
Publication Year :
2022

Abstract

Background: Lower socioeconomic status (SES) has consistently been associated with poorer outcomes in individuals with cystic fibrosis (CF). Previous studies have compared outcomes for children with and without private insurance coverage, however the potential role of changes in insurance status on early health outcomes in children with CF remains unknown.<br />Objectives: To describe the variability in insurance status in early childhood and to evaluate whether insurance variability was associated with poorer outcomes at age 6.<br />Methods: Retrospective observational study using the Cystic Fibrosis Foundation Patient Registry. Insurance status was defined as: always private (including Tricare), exclusively public, or intermittent private insurance (private insurance and exclusively public insurance in separate years) during the first 6 years of life. Outcomes at age 6 included body mass index (BMI) and FEV <subscript>1</subscript>  percent predicted (maxFEV <subscript>1</subscript> pp).<br />Results: From a 2000-2011 birth cohort (n = 8,109), 42.3% always had private insurance, 30.0% had exclusively public insurance, and 27.6% had intermittent private insurance. BMI percentiles did not differ between groups; however, children with intermittent private insurance and exclusively public insurance had a 3.3% and 6.6% lower maxFEV <subscript>1</subscript> pp at age 6, respectively, compared to those with always private insurance.<br />Conclusions: A substantial proportion of young children in a modern CF cohort have public or intermittent private insurance coverage. While public insurance has been associated with poorer health outcomes in CF, variability in health insurance coverage may also be associated with an intermediate risk of disparities in lung function as early as age 6.<br />Competing Interests: Declaration of Competing Interest All authors disclose that they have no financial interests in the subject of this manuscript. The funding sources have no role in the analysis or drafting of the manuscript.<br /> (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Details

Language :
English
ISSN :
1873-5010
Volume :
21
Issue :
1
Database :
MEDLINE
Journal :
Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society
Publication Type :
Academic Journal
Accession number :
34175244
Full Text :
https://doi.org/10.1016/j.jcf.2021.06.006