Abstract
Objective
Though stable insurance is important to support optimal child health, the reproducibility
of metrics to assess child health insurance retention at the state and county level
has not been examined. We sought to determine reproducibility of public insurance
retention rates for children using 3 different metrics at the state and county level.
Methods
Public health insurance retention for children was assessed using 3 different metrics
calculated from 2006–2009 Medicaid Analytic Extract data from 12 selected states.
The metrics were: 1) Duration: a prospective metric that quantifies the number of
newly enrolled children continuously enrolled in public insurance 6, 12, and 18 months
after initial enrollment during a selected period; (2) Infant Duration: assesses Duration
only among infants born during a selected period; (3) Coverage: a prospective metric
that quantifies the average percentage of time a selected population is enrolled over
an 18-month interval. Reproducibility of the metrics was assessed using a range of
sample sizes with resampling and determining changes in relative rankings of states/counties
by retention rate.
Results
All 3 metrics demonstrated reproducible estimates at the state level with sample sizes
of 2000, 5000, and 10,000. Reproducibility of relative rankings for child health insurance
retention of counties within states were sensitive to county child population size
and the amount of variability in retention rates within the county and at the state
level.
Conclusions
As health care reform unfolds, the complete set of these 3 reproducible metrics can
be used to evaluate multipronged and multilevel strategies to retain eligible children
in public health insurance.
Keywords
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Article Info
Publication History
Published online: November 21, 2014
Accepted:
September 28,
2014
Received:
October 18,
2013
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
