Effect of the North Carolina State Children's Health Insurance Program on Beneficiary Access to Care

Slifkin, Rebecca T.; Freeman, Victoria A.; Silberman, Pam

doi:10.1001/archpedi.156.12.1223

Cited by 32 publications

(24 citation statements)

References 12 publications

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Section: Health Care Utilization: Emergency Room Use and Immunizationsmentioning

confidence: 99%

“…14,15 With this information, programs have worked to increase access to regular health care providers by giving clients health care insurance. This proved successful for one demonstration project 15 but not for others who had provided either free health care, or in one situation, monetary incentives to promote health care utilization. [16][17][18] These conflicting results suggest that at least some low-income families, even when insured and with an identified health care provider, relied on the emergency room for non-urgent health care.…”

Section: Health Care Utilization: Emergency Room Use and Immunizationsmentioning

confidence: 99%

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Community- versus Individual-Level Indicators to Identify Pediatric Health Care Need

Zlotnick¹

2006

J Urban Health

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Increasingly, geographic information systems employing spatial data are being used to identify communities with poorer health care status. Since health care indicators are strongly linked to income, could these data, usually based on adult indicators, be used for pediatric health care need? We hypothesized that individuallevel indicators such as quality of life scales (QOL) would be better than communitylevel indicators at identifying families with poorer health care practices. Surveys and medical record reviews were used for a sample of 174 caregivers of young children. Lower level of income was associated with poorer scores on several QOL domains, and on the primary health practices (i.e., non-urgent emergency room use and lack of age-appropriate immunization status). One community-level indicator, the medically underserved area (MUA), was almost as good as the best individual-level indicators at predicting primary health care practices. The community-level indicator of MUA appears to meet its initial intent, providing information on the location of very lowincome individuals with high health care need even among a sample of Medicaidinsured children with an identified health care provider.

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Section: Health Care Utilization: Emergency Room Use and Immunizationsmentioning

confidence: 99%

Section: Health Care Utilization: Emergency Room Use and Immunizationsmentioning

confidence: 99%

Community- versus Individual-Level Indicators to Identify Pediatric Health Care Need

Zlotnick¹

2006

J Urban Health

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“…50,51 It is not clear why the NYS SCHIP seems to have such a large effect despite several factors that would tend to limit its potential impact. One possibility is that the existing health care system for near-poor children in NYS is able to function well if individuals are provided with health insurance.…”

Section: Impact Of the Nys Schip: A Changing Pattern Of Health Care Dmentioning

confidence: 99%

“…Evaluating the impact of SCHIP requires measurement of change in health measures after enrollment versus baseline measures before enrollment. Recent reports about 2 small SCHIP programs 50,51 noted improvements in access to care among enrollees.…”

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confidence: 99%

Improved Access and Quality of Care After Enrollment in the New York State Children's Health Insurance Program (SCHIP)

et al. 2004

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ABSTRACT. Background. Although many studies have noted that uninsured children have poorer access and quality of health care than do insured children, few studies have been able to demonstrate the direct benefits of providing health insurance to previously uninsured children. The State Children's Health Insurance Program (SCHIP), enacted as Title XXI of the Social Security Act, was intended to improve insurance coverage and access to health care for low-income, uninsured children. With limited state and federal resources for health care, continued funding of SCHIP requires demonstration of success of the program. As yet, little is known about the effectiveness of SCHIP on improving access and quality of care to enrollees.Objectives. To measure the impact of the New York State (NYS) SCHIP on access, utilization, and quality of health services for enrolled children.Design Setting. NYS, stratified into 4 regions. The NYS SCHIP is modeled on commercial insurance (32 managed care plans) and at the time of the study had 18% of SCHIP enrollees nationwide.Study Design. For the study group, the design used pre/poststudy telephone interviews of parents of children enrolling in the NYS SCHIP, with baseline interviews soon after enrollment and follow-up interviews 1 year after enrollment. Baseline interviews reflected the child's experience during the 1-year period before enrollment in SCHIP. The follow-up interviews reflected the 1-year period after enrollment in SCHIP. For the comparison group, the design used baseline interviews of a comparison group enrolled 1 year after the study group to test for secular trends; these interviews reflected the 1-year period before enrollment in SCHIP.Subjects. Children (n ‫؍‬ 2644) 0 to 18 years of age who enrolled in the NYS SCHIP for the first time (November 2000 to March 2001), stratified by age (0-5, 6-11, and 12-18 years), race/ethnicity (white non-Hispanic, black nonHispanic, and Hispanic; others excluded), and region of NYS. The comparison group consisted of 400 children. Telephone interviews were conducted in English or Spanish throughout the day and evening, 7 days per week, to obtain measures.Main Outcome Measures. Demographic and health measures (child and family characteristics, health status, presence of a special health care need, and prior health insurance), access (usual source of care [USC] and unmet needs for health care), utilization (visits for specific health services), and quality (continuity with USC and measures of primary care interactions). Analyses included bivariate tests, comparing the pre-SCHIP period to the 1-year period after enrollment in SCHIP. Multivariate models were computed to generate standardized populations comprised of key characteristics of the sample to test for differences in measures (after SCHIP versus before SCHIP), controlling for demographic characteristics.Results. Of the 2644 study-group children who completed the initial interview, 2290 (87%) completed the follow-up interview. Key measures for the pre-SCHIP period and short-term "pos...

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“…The results of studies from several states including Pennsylvania, 33 New York, 34 and Florida 35 demonstrate that children who were enrolled in a state insurance program had significant improvement in healthcare access, utilization, and quality of care. 9,34,[36][37][38][39][40] Analyses using more nationally representative data indicate that children with continuous public coverage had significantly better access and utilization of healthcare when compared with eligible but uninsured children, and had equivalent or better access and utilization compared to children with private coverage. [36][37][38]41 Thus, increasing rates of child insurance would improve children's well-being if it resulted in higher rates of preventative care use.…”

Section: Benefits Of Insurance Coverage For Childrenmentioning

confidence: 99%

Healthy and Ready to Learn: Effects of a School‐Based Public Health Insurance Outreach Program for Kindergarten‐Aged Children

Jenkins

2017

Journal of School Health

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Effect of the North Carolina State Children's Health Insurance Program on Beneficiary Access to Care

Abstract: The NCHC has successfully improved access to care for its enrollees.

Cited by 32 publications

References 12 publications

Community- versus Individual-Level Indicators to Identify Pediatric Health Care Need

Community- versus Individual-Level Indicators to Identify Pediatric Health Care Need

Improved Access and Quality of Care After Enrollment in the New York State Children's Health Insurance Program (SCHIP)

Healthy and Ready to Learn: Effects of a School‐Based Public Health Insurance Outreach Program for Kindergarten‐Aged Children

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