Estimating the prevalence of uninsured children: an evaluation of data from the National Survey of Children with Special Health Care Needs, 2001. Data evaluation and methods research.

Unlabelled: The National Survey of Children with Special Health Care Needs revealed that 8.3% of children under 18 years of age were uninsured, a rate lower than the rate estimated by other national surveys. This report presents the results of an evaluation of the quality of this estimate, based on analyses of non-response, question design, interviewer and respondent effects, and the weighing and estimation process. National and State-level statistics on health insurance coverage for children with special health care needs (CSHCN) and for children without special needs are included in an appendix.

Source of data: The National Survey of CSHCN is a survey module of the State and Local Area Integrated Telephone Survey. This survey of parents and guardians collected health insurance coverage information for a national sample of 215, 162 children. Data were collected from October 2000 through April 2002.

Results: Compared with other surveys, weighted data from the National Survey of CSHCN describe a population with a slightly larger proportion of Hispanic children and children from households with higher incomes. The National Survey of CSHCN was also the only survey to use a child-level design: A randomized experiment that varied the health insurance questions found that repeating the coverage questions for each child produced lower unisurance rates than household-level questions that first asked if anyone in the househol was insured.

Conclusion: Question design differences explain much of the discrepancy between survey estimates of the uninsurance rate, but a definitive conclusion regarding the relative accuracy of the uninsurance rates is not possible.