The 130th Annual Meeting of APHA

Abstract #49769

Victoria A. Freeman, RN, DrPH¹, Rebecca Slifkin, PhD², Pam C. Silberman, JD, DrPH², and Robert Schwartz, MA¹. (1) Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Airport Rd, CB #7590, Chapel Hill, NC 27599-7590, 919-966-6168, victoria_freeman@unc.edu, (2) Sheps Center for Health Services Research, UNC-Chapel Hill, 725 Airport Road, CB# 7590, Chapel Hill, NC 27599-7590

In 1998, North Carolina implemented North Carolina Health Choice for Children (NCHC), a stand-alone, fee-for-service SCHIP program. This study was designed to assess program effectiveness by exploring parental perception of access to care before and after enrollment in the program. Response rate to a mailed survey sent upon enrollment was 75% with a comparable response to the follow-up mailed survey sent one year later to baseline respondents. A total of 987 parents provided data for the pair-wise comparisons of access and qualitative analysis of attitudes. Parents reported improved access to well child care, acute medical care, and dental care in the year after enrollment. Improvement in access was most striking for older children. In bivariate analyses by previous insurance coverage, parents of older children (>5 years) insured by Medicaid immediately prior to NCHC reported improvement in access but even greater gains were reported for children of all ages who had previously been uninsured. Despite improved access reported by many parents, data indicated that fewer of the youngest children, most of whom had been previously insured by Medicaid, received well care after enrollment than before suggesting the need for NCHC program of outreach to parents of young children, similar to that available under Medicaid. Parents reported satisfaction with the insurance plan, citing not only the general access to care it afforded their children but also specific covered benefits and improved availability of providers. They also reported improvement in their child’s health status, ability to perform daily activities, and school absenteeism rate.

Learning Objectives:

• Describe change in access to care after enrollment in an SCHIP program.
• Compare change in access to care based on previous insurance coverage.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.