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Cited by 27Adolescent and Pediatric HealthcareHealthcare Policy and ManagementFamily and Disability Support Research

Does private insurance adequately protect families of children with mental health disorders?

Open access
Busch, Susan H., Barry, Colleen L.·2009·PEDIATRICS
DOI 10.1542/peds.2009-1255kPMC PMC2805472
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Abstract

OBJECTIVE: Although private insurance typically covers many health care costs, the challenges faced by families who care for a sick child are substantial. These challenges may be more severe for children with special health care needs (CSHCN) with mental illnesses than for other CSHCN. Our objective was to determine if families of privately insured children who need mental health care face different burdens than other families in caring for their children. PATIENTS AND METHODS: We used the 2005-2006 National Survey of Children With Special Health Care Needs (NS-CSHCN) to study privately insured children aged 6 to 17 years. We compared CSHCN with mental health care needs (N = 4918) to 3 groups: children with no special health care needs (n = 2346); CSHCN with no mental health care needs (n = 16250); and CSHCN with no mental health care need but a need for other specialty services (n = 7902). The latter group was a subset of CSHCN with no mental health care need. We used weighted logistic regression and study outcomes across 4 domains: financial burden; health plan experiences; labor-market and time effects; and parent experience with services. RESULTS: We found that families of children with mental health care needs face significantly greater financial barriers, have more negative health plan experiences, and are more likely to reduce their labor-market participation to care for their child than other families. CONCLUSIONS: Families of privately insured CSHCN who need mental health care face a higher burden than other families in caring for their children. Policies are needed to help these families obtain affordable, high-quality care for their children.

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  • One study found that 43% of parents of children with special health care needs involving an MH/SUD condition reported out-of-pocket spending exceeding $1000 annually, compared with 22% of parents of CSHCN involving only a medical condition.

    “One study found, for example, that 43% of parents of children with special health care needs (CSHCN) that involved an MH/SUD condition reported OOP spending exceeding $1000 annually, compared with only 22% of parents of CSHCN that involved only a medical condition.4”

    From Parity and Out-of-Pocket Spending for Children With High Mental Health or Substance Abuse Expenditures (2013) · cites this paper as [4]

    The Discussion (page unavailable) reports that 43% of privately insured families of children with mental health care needs spent over $1,000 out of pocket. The Results (page unavailable) say costs were lower for children with special health care needs but no mental health care need, but our copy does not give the claimed 22% figure. The study concerns mental health care needs in privately insured children, not the broader MH/SUD group stated in the claim. (LLM, conf=0.86)

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Research works printed but not linked: 1

  1. [18]Thomas CR Holzer CE The continuing shortage of child and adolescent psychiatrists J Am Acad Child Adolesc Psychiatry 2006 45 9 16840879

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Authors
Busch, S. H., & Barry, C. L.
Affiliations
Yale University (US)
Corresponding author
Busch, Susan H.
ORCID
Venue
PEDIATRICS
Publisher
American Academy of Pediatrics (AAP)
Published
2009-12-01
Volume
124
Issue
Supplement_4
Pages
S399-S406
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.2009-1255k
PMC
PMC2805472
OpenAlex
W2016332383
Cited by
27
References
22
Citations by year
2025: 1 · 2023: 4 · 2022: 1 · 2020: 2 · 2019: 1 · 2018: 2 · 2016: 2 · 2015: 1 · 2014: 1 · 2013: 2 · 2012: 3
FWCI
9.15
Type
journal article
Language
en
Open access
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R01MH080883)
Topics
  • Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
  • Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
Keywords
private health insurance, children with special health care needs, child psychopathology, family caregiver burden, financial burden, parental labor force participation, time constraints, National Survey of Children with Special Health Care Needs
MeSH terms
Adolescent, Mental Disorders, Child, Child Welfare, Family, Female, Health Services Accessibility, Health Services Needs and Demand, Humans, Insurance, Health, Male, Mental Health Services, Quality of Health Care, Socioeconomic Factors, Logistic Models, Health Care Costs, Patient Satisfaction, Cost of Illness, Insurance Coverage, Children with Disabilities, Disabled Children

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