Date of Award

Summer 7-2022

Document Type

Open Access Thesis

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

First Advisor

Margit Berman, Ph.D., L.P.

Second Advisor

Marcia Bennett, Ph.D., L.P.

Third Advisor

Abby Hughes-Scalise, Ph.D., L.P

Abstract

Epilepsy is the leading neurological disorder among children, and requires specialized health care (Zack & Kobau, 2015). However, many patients with seizures do not receive appropriate specialized care (Begley et al., 2009; Burneo et al., 2009). This study examined the impact of health insurance type on access to and use of specialty care and mental health care among pediatric patients, ages 3-17, whose parents reported that they had experienced at least one seizure in the last year. This study was a secondary analysis of data collected in the 2011 (n = 77) and 2016 (n = 87) National Health Survey and investigated whether having private, public, or no insurance affected these children’s access to and utilization of specialty and mental health care. It was hypothesized that children with private insurance would have greater access to and utilization of both types of care. Whether severity of mental health symptoms among these children affected mental health care was also investigated, with the hypothesis that those with more severe symptoms would have less access and utilization. Changes in the relationship between insurance type and mental health care over time were also investigated, with the hypothesis that the disparity in access to and utilization of mental health care among participants who had private vs. public health insurance would be larger in 2011 than in 2016. Contrary to these hypotheses, there were no significant differences in access to and use of specialty care and mental health care across insurance types (public, private, and non-insured). Mental health severity was significantly associated with participants’ access and use of mental health care, but the relationship was positive, not negative as hypothesized. There were no significant differences between 2011 and 2016 in participants’ access to and use of mental health care. Insurance type, symptom severity, and changes related to Affordable Care Act implementation may only be a small factor in disparities of care affecting pediatric seizure patients.

Identifier

SC 11.PsyD.2022.DelosSantos.S

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