The Balanced Budget Act of 1997 authorizes $20 billion for states to expand health insurance coverage among uninsured low-income children.
This study identifies lessons learned from the Medicaid Extension Demonstration, which was authorized by Congress to experiment with innovative approaches to providing health care coverage for low-income children.
The three programs compare and contrast a variety of features that may enhance or detract from access, including a traditional Medicaid expansion, a private indemnity model, and a comprehensive managed care delivery system.
Two waves of telephone surveys were conducted with a sample of parents of children participating in the Medicaid Extension Demonstration, and a comparison group of parents of children who were eligible but not participating.
Descriptive and multivariate analyses were conducted to determine the impact of the demonstration on access to care.
Compared with those who were uninsured, children in the managed care program were more likely to have a medical home and a physician visit and were less likely to have an emergency room visit, and had lower levels of unmet need.
Outcomes across the other two demonstration programs were less favorable.
This study suggests that simply providing a Medicaid card or private indemnity insurance card is not enough to ensure access to care. (...)
Mots-clés Pascal : Pauvreté, Accessibilité, Service santé, Soin, Enfant, Homme, Nourrisson, Assurance maladie, Système santé, Déterminant, Influence, Statut socioéconomique
Mots-clés Pascal anglais : Poverty, Accessibility, Health service, Care, Child, Human, Infant, Health insurance, Health system, Determinant, Influence, Socioeconomic status
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0336098
Code Inist : 002B30A03B. Création : 16/11/1999.