This Article  • Full text  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (42)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Psychiatry  • Alert me on articles by topic

Jeffrey S. Harman, PhD; George E. Childs, BA; Kelly J. Kelleher, MD, MPH

Arch Pediatr Adolesc Med. 2000;154:1114-1117.

Objective  To determine the percentage of children with mental health diagnoses and utilization and expenditures of mental health services among children in foster care compared with other children receiving Medicaid, including those with disabilities.

Design  Analysis of Medicaid claim and eligibility records in southwestern Pennsylvania for fiscal year 1995.

Population  A total of 39,500 children between ages 5 and 17 years continuously eligible for Medicaid in southwestern Pennsylvania were included in the analysis.

Main Outcome Measures  Percentage of children with mental health diagnoses and mental and general health care utilization and expenditures classified by participation in foster care and Medicaid eligibility.

Results  Children in foster care were 3 to 10 times more likely to receive a mental health diagnosis, had 6.5 times more mental health claims, were 7.5 times more likely to be hospitalized for a mental health condition, and had mental health expenditures that were 11.5 times greater ($2082 vs $181) than children in the Aid to Families With Dependent Children (AFDC) program. Overall, utilization rates, expenditures, and prevalence of psychiatric conditions for children in foster care were comparable with those of children with disabilities.

Conclusions  Children in foster care are significantly more likely to suffer from mental health conditions and use more mental health and general health services than AFDC children. Service use and expenditures are comparable with those of disabled children, suggesting that reimbursement rates and care management for children in foster care need to be reexamined.

From the Child Services Research and Development Program, University of Pittsburgh School of Medicine, Pittsburgh, Pa.

RELATED ARTICLE

The Shame of Foster Care Health Services
Abraham B. Bergman
Arch Pediatr Adolesc Med. 2000;154(11):1080-1081.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Medical and Mental Health of Children Entering the Utah Foster Care System
Steele and Buchi
Pediatrics 2008;122:e703-e709.
ABSTRACT | FULL TEXT  

Racial/Ethnic Minority Children's Use of Psychiatric Emergency Care in California's Public Mental Health System
Snowden et al.
Am. J. Public Health 2008;98:118-124.
ABSTRACT | FULL TEXT  

Psychotropic Medication Patterns Among Youth in Foster Care
Zito et al.
Pediatrics 2008;121:e157-e163.
ABSTRACT | FULL TEXT  

Relationship Between Entry Into Child Welfare and Mental Health Service Use
Leslie et al.
Psychiatr. Serv. 2005;56:981-987.
ABSTRACT | FULL TEXT  

Effect of Medicaid Eligibility Category on Racial Disparities in the Use of Psychotropic Medications Among Youths
Zito et al.
Psychiatr. Serv. 2005;56:157-163.
ABSTRACT | FULL TEXT  

Race, Urban Community Stressors, and Behavioral and Emotional Problems of Children With Special Health Care Needs
Jaffee et al.
Psychiatr. Serv. 2005;56:63-69.
ABSTRACT | FULL TEXT  

Contextual Predictors of Mental Health Service Use Among Children Open to Child Welfare
Hurlburt et al.
Arch Gen Psychiatry 2004;61:1217-1224.
ABSTRACT | FULL TEXT  

Multimodal Treatment for ADHD Among Youths in Three Medicaid Subgroups: Disabled, Foster Care, and Low Income
dosReis et al.
Psychiatr. Serv. 2004;55:1041-1048.
ABSTRACT | FULL TEXT  

Use of Mental Health Services Among Older Youths in Foster Care
McMillen et al.
Psychiatr. Serv. 2004;55:811-817.
ABSTRACT | FULL TEXT  

Placement Stability and Mental Health Costs for Children in Foster Care
Rubin et al.
Pediatrics 2004;113:1336-1341.
ABSTRACT | FULL TEXT  

Evaluation of a New Mental Health Service for Looked after Children
Callaghan et al.
Clin Child Psychol Psychiatry 2004;9:130-148.
ABSTRACT  

Mental Health Services Utilization by Maltreated Children: Research Findings and Recommendations
Staudt
Child Maltreat 2003;8:195-203.
ABSTRACT  

Comprehensive Assessments for Children Entering Foster Care: A National Perspective
Leslie et al.
Pediatrics 2003;112:134-142.
ABSTRACT | FULL TEXT  

Continuity of Care for Children in Foster Care
DiGiuseppe and Christakis
Pediatrics 2003;111:e208-213.
ABSTRACT | FULL TEXT  

Beyond Child Protection: Promoting Mental Health for Children and Families in the Child Welfare System
Webb and Harden
Journal of Emotional and Behavioral Disorders 2003;11:49-58.
ABSTRACT  

The Shame of Foster Care Health Services
Bergman
Arch Pediatr Adolesc Med 2000;154:1080-1081.
FULL TEXT