The Association of Health Insurance and Disease Impairment with Reported Asthma Prevalence in U.S. Children

While children with persistent asthma symptoms are treated similarly regardless of insurance status, insured children with intermittent symptoms are more likely than uninsured children to be diagnosed and receive treatment, suggesting insuring more asthmatic children is unlikely to result in treatment cost savings.

It is known that insuring kids with asthma can improve outcomes. But there has been little study of the relationship between children’s insurance status and the diagnosis and treatment of asthma, a question that has cost implications as health insurance is expanded to cover more children. This study used a national sample of 11,714 children under the age of 18, derived from a population-based survey of U.S. households. Eleven percent of the sample was uninsured; 10 percent had an asthma diagnosis; 87 percent reported no symptoms; 5 percent reported intermittent symptoms; and 8 percent reported persistent symptoms.

Key Findings:

  • The odds of insured children with intermittent symptoms being diagnosed with asthma were four times greater than for uninsured children with such symptoms. But for kids whose symptoms were persistent, there was no difference in diagnosis rates based on insurance status.
  • The odds of insured children with intermittent symptoms receiving asthma-control therapy with inhaled corticosteroids were also four times greater than for their uninsured counterparts.
  • The odds were five times greater that insured children with intermittent symptoms were likely to receive acute care for an asthma attack, compared to uninsured kids with similar symptoms.

These results suggest that, while asthmatic children may be better diagnosed and treated when they are insured, insuring these children does not save money by reducing the need for acute care. The study also suggests there may be many undiagnosed asthmatic children. The authors conclude it is probably unrealistic to anticipate that insuring more children with asthma will result in treatment cost savings.

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