{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:04:49Z","timestamp":1777525489556,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2011,8,8]],"date-time":"2011-08-08T00:00:00Z","timestamp":1312761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Pediatr (Phila)"],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:p>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\u2019s 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.<\/jats:p>","DOI":"10.1177\/0009922811410229","type":"journal-article","created":{"date-parts":[[2011,8,9]],"date-time":"2011-08-09T20:31:02Z","timestamp":1312921862000},"page":"963-973","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Continuity of Insurance Coverage and Ambulatory Care\u2013Sensitive Hospitalizations\/ED Visits"],"prefix":"10.1177","volume":"50","author":[{"given":"David J.","family":"Becker","sequence":"first","affiliation":[{"name":"University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin L.","family":"Blackburn","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meredith L.","family":"Kilgore","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Morrisey","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bisakha","family":"Sen","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cathy","family":"Caldwell","sequence":"additional","affiliation":[{"name":"Alabama Department of Public Health, Montgomery, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nir","family":"Menachemi","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2011,8,8]]},"reference":[{"key":"bibr1-0009922811410229","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.27.6.w533"},{"key":"bibr2-0009922811410229","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199405193302006"},{"key":"bibr3-0009922811410229","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.17.2.127"},{"key":"bibr4-0009922811410229","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199201000-00003"},{"key":"bibr5-0009922811410229","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.9.4.158"},{"key":"bibr6-0009922811410229","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1992.03490170060026"},{"key":"bibr7-0009922811410229","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.87.5.811"},{"key":"bibr8-0009922811410229","volume-title":"Access to Health Care in America","author":"Millman M","year":"1993"},{"key":"bibr9-0009922811410229","first-page":"473","volume":"7","author":"Friedman B","year":"2001","journal-title":"Am J Manag Care"},{"key":"bibr10-0009922811410229","doi-asserted-by":"publisher","DOI":"10.1177\/1077558708318283"},{"key":"bibr11-0009922811410229","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpubeco.2003.05.004"},{"key":"bibr12-0009922811410229","doi-asserted-by":"publisher","DOI":"10.1162\/rest.89.3.400"},{"key":"bibr13-0009922811410229","doi-asserted-by":"publisher","DOI":"10.1177\/0009922807306166"},{"key":"bibr14-0009922811410229","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03530040033037"},{"key":"bibr15-0009922811410229","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1542\/peds.106.S3.942","volume":"106","author":"Parker JD","year":"2000","journal-title":"Pediatrics"},{"key":"bibr16-0009922811410229","doi-asserted-by":"publisher","DOI":"10.1542\/peds.112.5.1021"},{"key":"bibr17-0009922811410229","volume-title":"Measures of Pediatric Health Care Quality Based on Hospital Administrative Data: The Pediatric Quality Indicators","author":"Agency for Healthcare Research and Quality","year":"2006"},{"key":"bibr18-0009922811410229","volume-title":"Guide to Prevention Quality Indicators: Hospital Admission for Ambulatory Care Sensitive Conditions (Version 3.1)","author":"Agency for Healthcare Research and Quality","year":"2007"},{"key":"bibr19-0009922811410229","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a113439"},{"key":"bibr20-0009922811410229","volume-title":"Potentially Avoidable Pediatric Hospitalizations in Tennessee","author":"Chang CF","year":"2005"},{"key":"bibr21-0009922811410229","unstructured":"McCarthy D, Leatherman S. Performance snapshots: hospitalizations for ambulatory sensitive conditions, The Commonwealth Fund, New York, NY. http:\/\/www.commonwealthfund.org\/Content\/Performance-Snapshots\/Overuse-of-Health-Care-Services\/Hospitalizations-for-Ambulatory-Care\u20138211-Sensitive-Conditions.aspx Accessed December 10, 2010."},{"key":"bibr22-0009922811410229","unstructured":"Inkelas M, Barreto P. Rates of emergency department use for ambulatory sensitive conditions in the Los Angeles Healthy Kids program. Urban Institute Research Brief. http:\/\/www.urban.org\/uploadedpdf\/412165-ambulatory-sensitive-conditions.pdf. 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