The impact of realized access to care on health-related quality of life: A two-year prospective cohort study of children in the California State Children’s Health Insurance Program - 09/08/11
, James W. Varni, PhD, Lesley Cummings, MPA, Matthias Schonlau, PhD
Reprint requests: Michael Seid, PhD, RAND Corporation, 1776 Main Street, M4W, Santa Monica, CA 90407.Résumé |
Objective |
To examine the effect of realized access to care (problems getting care, access to needed care) on health-related quality of life (HRQOL) in the California State Children’s Health Insurance Program.
Study design |
This was a prospective cohort study (n = 4,925; 70.5% [3438] had complete data). Surveys were taken at enrollment and after 1 and 2 years in the program. Parents and children reported HRQOL (PedsQL™ 4.0 Generic Core Scales). Repeated-measures analysis accounted for within-person correlation and adjusted for baseline PedsQL™, baseline realized access, race/ethnicity, language, chronic health condition, and having a regular physician.
Results |
Realized access to care during the prior year was related to HRQOL for each subsequent year. Foregone care and problems getting care were associated with decrements of 3.5 (P < .001) and 4.5 (P < .001) points for parent proxy-report PedsQL™ and with decrements of 3.2 (P < .001) and 4.4 (P < .001) points for child self-report PedsQL™. Improved realized access resulted in higher PedsQL™ scores, continued realized access resulted in sustained PedsQL™ scores, and foregone care resulted in cumulative declines in PedsQL™ scores.
Conclusions |
Realized access to care is associated with statistically significant and clinically meaningful changes in HRQOL in children enrolled in the California State Children’s Health Insurance Program.
Le texte complet de cet article est disponible en PDF.Abbreviations : HF, HRQOL, SCHIP
Plan
| Supported by a grant from the David and Lucille Packard Foundation. The funding agency played no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript. Dr Varni holds the copyright and the trademark for the PedsQL™ and receives financial compensation from the Mapi Research Trust, which is a nonprofit research institute that charges distribution fees to for-profit companies that use the Pediatric Quality of Life Inventory™. |
Vol 149 - N° 3
P. 354-361 - septembre 2006 Retour au numéro
Article précédent
- Quality of life and psychological adjustment in children and adolescents with neurofibromatosis type 1
- Anna Graf, Markus A. Landolt, Andrea Capone Mori, Eugen Boltshauser
- Fifty Years Ago in The Journal of Pediatrics : Aminophylline (theophylline ethylenediamine) poisoning in children
- Leslie Hendeles
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?