Costs a Barrier to Asthma Care for Some Kids
High co-pays prevent some children from seeing a doctor or getting needed meds, study finds
For the study, Fung's team telephoned 769 parents of children with asthma, ages 4 to 11. The researchers asked what role costs played in accessing care for their child.
Among the children, one-quarter had publicly funded Medicaid or the Children's Health Insurance Program. About 22 percent were covered by private insurance and had household incomes at or below 250 percent of the federal poverty level -- $47,725 a year for a family of three. About 18 percent had high co-pays for all services -- for example, $75 or more for an ER visit.
Among parents at or below 250 percent of the federal poverty level, those with high co-pays were far less likely to take their children to a doctor than similar parents with lower co-pays -- about 4 percent compared to almost 32 percent, the researchers found. They were also less likely to take their sick children to the emergency room -- about 1 percent versus 19 percent.
Those same parents with high co-pays were also less likely to get care for their children than parents with higher incomes or those with Medicaid subsidies, the study found.
Other cost-related findings:
- Nearly 3 percent of parents said they changed to a cheaper medicine, and nearly 10 percent said they gave their child less medicine than prescribed because of cost.
- Four out of 10 parents who reduced their child's medication admitted it affected their child's asthma care or control.
- Almost 8 percent of parents said they delayed or skipped taking their child to the doctor. Over 5 percent reported they delayed or avoided going to the emergency room.
- Among those who put off doctor visits, 38 percent said it affected their child's asthma care or control. More than one-quarter who avoided an ER trip because of expenses said the same.
- Almost 16 percent of parents said they borrowed money or cut back on necessities to pay for medical care for their children.
With the Affordable Care Act in "full swing" now, Fung said it's important to keep monitoring its effects and close any unintended gaps in coverage.