Objective: To examine whether income-related disparities in the burden of children’s out-of-pocket health care expenditures have diminished with the expansions in public insurance for children in low-income families....Objective: To examine whether income-related disparities in the burden of children’s out-of-pocket health care expenditures have diminished with the expansions in public insurance for children in low-income families. Design: We compared absolute financial burden (out-of-pocket expenditures per child) and relative financial burden (out-of-pocket expenditures per child as a proportion of family income) among children aged 0 to 18 years in 6 poverty level groups using the 1980 National Medical Care Utilization and Expenditure Survey and the 2000 Medical Expenditure Panel Survey. Regression models were used to assess whether disparities in financial burden diminished between 1980 and 2000. Results: There were significant reductions (P<.01) in absolute burden over time for children above 200% of the federal poverty level. Relative financial burden decreased significantly (P<.01) for all of the income groups, ranging from a reduction of 36.49% for those below 100% of the federal poverty level (95% CI, - 49.54% to - 20.07% ) to a reduction of 46.69% for those at or above 300% of the federal poverty level (95% CI, - 54.43% to - 37.62% ). For low-income children, relative financial burden was 49.49% less with public insurance (95% CI, - 66.24% to - 24.35% ) and 79.14% greater with private insurance (95% CI, 9.31% to 193.59% ) than relative financial burden for low-income children without insurance. Conclusions: While the financial burden of children’s out-of pocket health care expenditures has decreased for all of the income groups over time, socioeconomic disparities persist. However, public insurance coverage appears to mitigate the financial burden for low-income children.展开更多
Purpose: To identify the characteristic ocular findings in patients with craniofacial cleft (CFC). Methods: Ophthalmologic examination wa s performed for a 16-year-old girl with no. 3 CFC and a 3-year-old boy with no....Purpose: To identify the characteristic ocular findings in patients with craniofacial cleft (CFC). Methods: Ophthalmologic examination wa s performed for a 16-year-old girl with no. 3 CFC and a 3-year-old boy with no. 5 CFC. Results: Exotropia was found in the 3-year-old boy with no. 5 CFC i nvolving the lateral orbit, and esotropia in the 16-year-old girl with craniof acial cleft no. 3 involving the medial orbit. Hypotropia, lower eyelid coloboma, amblyopia and an absence of stereopsis were common to both patients. Visual acu ity was improved from hand motion to 20/30 by means of occlusion therapy for amb lyopia in the 3-year-old boy. Strabismus surgery resulted in exophoria of 8 pr ism diopters (PD) in the 3-year-old boy and left esotropia of 8 PD in the 16- year-old girl. Conclusions: Amblyopia, hypotropia, esotropia (no. 3) and exotro pia (no. 5) should be verified in cases of CFC nos. 3 and 5. Ophthalmologic exam ination and early intervention for amblyopia may be mandatory for patients with CFC involving the orbit.展开更多
文摘Objective: To examine whether income-related disparities in the burden of children’s out-of-pocket health care expenditures have diminished with the expansions in public insurance for children in low-income families. Design: We compared absolute financial burden (out-of-pocket expenditures per child) and relative financial burden (out-of-pocket expenditures per child as a proportion of family income) among children aged 0 to 18 years in 6 poverty level groups using the 1980 National Medical Care Utilization and Expenditure Survey and the 2000 Medical Expenditure Panel Survey. Regression models were used to assess whether disparities in financial burden diminished between 1980 and 2000. Results: There were significant reductions (P<.01) in absolute burden over time for children above 200% of the federal poverty level. Relative financial burden decreased significantly (P<.01) for all of the income groups, ranging from a reduction of 36.49% for those below 100% of the federal poverty level (95% CI, - 49.54% to - 20.07% ) to a reduction of 46.69% for those at or above 300% of the federal poverty level (95% CI, - 54.43% to - 37.62% ). For low-income children, relative financial burden was 49.49% less with public insurance (95% CI, - 66.24% to - 24.35% ) and 79.14% greater with private insurance (95% CI, 9.31% to 193.59% ) than relative financial burden for low-income children without insurance. Conclusions: While the financial burden of children’s out-of pocket health care expenditures has decreased for all of the income groups over time, socioeconomic disparities persist. However, public insurance coverage appears to mitigate the financial burden for low-income children.
文摘Purpose: To identify the characteristic ocular findings in patients with craniofacial cleft (CFC). Methods: Ophthalmologic examination wa s performed for a 16-year-old girl with no. 3 CFC and a 3-year-old boy with no. 5 CFC. Results: Exotropia was found in the 3-year-old boy with no. 5 CFC i nvolving the lateral orbit, and esotropia in the 16-year-old girl with craniof acial cleft no. 3 involving the medial orbit. Hypotropia, lower eyelid coloboma, amblyopia and an absence of stereopsis were common to both patients. Visual acu ity was improved from hand motion to 20/30 by means of occlusion therapy for amb lyopia in the 3-year-old boy. Strabismus surgery resulted in exophoria of 8 pr ism diopters (PD) in the 3-year-old boy and left esotropia of 8 PD in the 16- year-old girl. Conclusions: Amblyopia, hypotropia, esotropia (no. 3) and exotro pia (no. 5) should be verified in cases of CFC nos. 3 and 5. Ophthalmologic exam ination and early intervention for amblyopia may be mandatory for patients with CFC involving the orbit.
