Continuity of insurance coverage and ambulatory care-sensitive hospitalizations/ED visits: Evidence from the children's health insurance program

Academic Article


  • Objective: To assess the effects of continuity of insurance coverage on treatment of ambulatory-care sensitive conditions (ACSC). Study Population: 42,382 children enrolled in ALL Kids (Alabama Children's Health Insurance Program) for 3 or more years. Methods: We model annual hospitalizations and ED visits for six ACSCs identified by the AHRQ - bacterial pneumonia, dehydration, perforated appendix, urinary tract infection, gastroenteritis, and severe ear, nose and throat infection. Results: In unadjusted models, we find lower risk of ACSC hospitalizations and ED visits in the second and third years of continuous enrollment. Risk of hospitalization in year 3 was significantly lower for pneumonia (OR 0.608, 95% CI: 0.421-0.878) and gastroenteritis (OR 0.549, 95% CI: 0.404-0.746). These beneficial effects of duration of coverage disappear after controlling for age, year and other enrollee characteristics. Conclusions: Hospitalizations and ED visits for ACSCs are rare and do not decrease with additional years of coverage. © SAGE Publications 2011.
  • Published In

    Digital Object Identifier (doi)

    Author List

  • Becker DJ; Blackburn JL; Kilgore ML; Morrisey MA; Sen B; Caldwell C; Menachemi N
  • Start Page

  • 963
  • End Page

  • 973
  • Volume

  • 50
  • Issue

  • 10