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Genevieve Kenney, PhD, Health Policy Center, Urban Institute, 2100 M Street, NW, Washington, DC 20037, 202-261-5568, jkenney@ui.urban.org
Research Objectives: To estimate the effects of SCHIP on access to care and use of health services among children who enroll in ten states that account for over 60 percent of all SCHIP enrollees.
Study design: Impact estimates are derived by contrasting the access and use experiences of SCHIP enrollees who have been enrolled in the program for at least five months to the pre-SCHIP experiences of a separate sample of children who had just enrolled in the program. Regression models are used to estimate impacts that control for county of residence and observable child and family characteristics. Data are from the 2002 Congressionally-Mandated Survey of SCHIP Enrollees and Disenrollees in Ten States. Estimates are made for five different types of access and use indicators: 1) service use; 2) unmet need; 3) attitudes and stress; 4) presence and type of usual source of care and 5) provider communication and accessibility.
Population Studied: Children aged 0-18 years.
Results: Relative to the pre-SCHIP experiences of recent enrollees, established enrollees have fewer unmet health needs, their parents have less stress and worry about meeting their children’s health care needs, and they are more likely to have a usual source for both medical and dental care, other things equal. The greatest improvements are found relative to recent enrollees who were uninsured for all six months prior to enrolling. Improvements are found with additional outcomes related to service use, financial burden, and provider communication and accessibility. These findings are robust with respect to alternative specifications and the general patterns hold up in each of the 10 individual states.
Conclusions: These findings indicate SCHIP is having positive impacts on the lives of the children who enroll. SCHIP appears to be affording children greater access to the health care they need, which in turn is causing parents to have greater peace of mind about meeting their children’s health care needs. The fact that improvements are found in 10 very different states indicates that positive impacts are not limited to one state or to one type of SCHIP program. Additional analysis is needed to assess quality of care under SCHIP and impacts on the health and functioning of children.
Funding Source: The Assistant Secretary for Planning and Evaluation, United States Department of Health and Human Services.
Learning Objectives:
Keywords: Access to Care, Insurance
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.