Differences in Health Care Needs, Health Care Utilization, and Health Care Outcomes Among Children With Special Health Care Needs in Ohio

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Abstract

This study explores comparative differentials in health care needs, health care utilization, and health status between Medicaid and private/employer-sponsored insurance (ESI) among a statewide population of children with special health care needs (CSHCN) in Ohio.

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Most cited references 18

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Prevalence and predictors of underinsurance among low-income adults.

Hema Magge, Howard J Cabral, Lewis E Kazis … (2013)

Millions of adults will gain Medicaid or private insurance in 2014 under the Affordable Care Act, and prior research shows that underinsurance is common among middle-income adults. Less is known about underinsurance among low-income adults, particularly those with public insurance. To compare rates of underinsurance among low-income adults with private versus public insurance, and to identify predictors of being underinsured. Descriptive and multivariate analysis of data from the 2005-2008 Medical Expenditure Panel Survey. Adults 19-64 years of age with family income less than 125 % of the Federal Poverty Level (FPL) and full-year continuous coverage in one of four mutually exclusive insurance categories (N = 5,739): private insurance, Medicaid, Medicare, and combined Medicaid/Medicare coverage. Prevalence of underinsurance among low-income adults, defined as out-of-pocket expenditures greater than 5 % of household income, delays/failure to obtain necessary medical care due to cost, or delays/failure to obtain necessary prescription medications due to cost. Criteria for underinsurance were met by 34.5 % of low-income adults. Unadjusted rates of underinsurance were 37.7 % in private coverage, 26.0 % in Medicaid, 65.1 % in Medicare, and 45.1 % among Medicaid/Medicare dual enrollees. Among underinsured adults, household income averaged $6,181 and out-of-pocket spending averaged $1,115. Due to cost, 8.1 % and 12.8 % deferred or delayed obtaining medical care or prescription medications, respectively. Predictors of underinsurance included being White, unemployed, and in poor health. After multivariate adjustment, Medicaid recipients were significantly less likely to be underinsured than privately insured adults (OR 0.22, 95 % CI 0.17-0.28). Greater than one-third of low-income adults nationally were underinsured. Medicaid recipients were less likely to be underinsured than privately insured adults, indicating potential benefits of expanded Medicaid under health care reform. Nonetheless, more than one-quarter of Medicaid recipients were underinsured, highlighting the importance of addressing cost-related barriers to care even among those with public coverage.

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How well does Medicaid work in improving access to care?

Sharon Long, Teresa Coughlin, Jennifer King (2005)

To provide an assessment of how well the Medicaid program is working at improving access to and use of health care for low-income mothers.

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Role of insurance for children with special health care needs: a synthesis of the evidence.

Aimee Jeffrey, Paul Newacheck (2006)

Children with special health care needs constitute a particularly vulnerable subpopulation of children. Health insurance coverage has the potential to enhance access to care and improve the quality of life for these children while protecting their families from financially burdensome health care expenses. The purpose of this review is to assess and synthesize recent research in the peer-reviewed literature pertaining to the role of insurance for children with special health care needs. A marked increase in the volume of research on this topic makes this an opportune time to summarize these contributions and begin the process of formalizing an evidence base that can inform health policy decisions. Our intention is to further the evidence base by providing a literature-driven assessment of the role of health insurance in influencing access, utilization, satisfaction, quality, expenditures, and health outcomes for children with special health care needs.

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Author and article information

Journal

Title: Journal of Public Health Management and Practice

Abbreviated Title: Journal of Public Health Management and Practice

Publisher: Ovid Technologies (Wolters Kluwer Health)

ISSN (Print): 1078-4659

Publication date Created: 2017

Publication date (Print): 2017

Volume: 23

Issue: 1

Pages: e1-e9

Article

DOI: 10.1097/PHH.0000000000000403

PubMed ID: 27870721

SO-VID: c6a19873-0d56-44e2-8673-551bdcb7ada0

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