HMS Study Finds Low Use of Asthma Insurance Coverage Among Young Adults

A recent study at Harvard Medical School found that young adults in the United States between the ages of 18 and 25 utilized less health insurance coverage for their chronic asthma than adolescents between the ages of 14 and 18 did.

“As a pediatrician, I knew that many adolescents with chronic diseases ‘slip through the cracks’ as they transition into young adulthood,” said Kao-Ping Chua, the leader of the study and a clinical fellow at HMS. “I wanted to find out how much of this was due to lack of health insurance.”

Chua, along with co-authors Mark A. Schuster and J. Michael McWilliams, found that while adolescents were more likely to use preemptive and primary care, young adults more frequently were treated in emergency rooms.

But though young adults with asthma were less likely to have health care than adolescents, this did not explain all of the variation in treatment.

The study, which was published by the science journal “Pediatrics” on April 22, found that differences in insurance coverage accounted for 32 percent of young adults’ decrease in use of primary care. It also found that between 47 and 61 percent of problems that occur as a result of lack of access to medicine or medical care were explained by the differences in insurance coverage, leaving a significant amount of the difference to be explained by other means.

“I was surprised by how strongly some of the social factors predicted changes in the health care utilization patterns of young adults with asthma,” Chua said.

Chua added that young adults who do not live with their parents, attend school, or have coverage through employment, are more likely to lack proper coverage for their chronic conditions. The study showed that this pattern is correlated with age.

With the implementation of the Patient Protection and Affordable Care Act in 2010, which requires that insurance plans allow young adults to stay covered by their families’ plans until the age of 26, there may be a change in the pattern of coverage and the effect of socioeconomic factors.

“It would be interesting to examine whether these insurance expansions help improve the care that young adults with asthma receive,” Chua said.

In the analysis, however, Chua says that this study raises more questions than it answers.

“Asthma care for young adults deteriorates in young adulthood and [there are] a few potential mediators for this deterioration,” Chua said. “We don’t know exactly what we can do about it.”