 |
|
Effect of the North Carolina State Children's Health Insurance Program on Beneficiary Access to Care
Rebecca T. Slifkin, PhD;
Victoria A. Freeman, RN, DrPH;
Pam Silberman, JD, DrPH
Arch Pediatr Adolesc Med. 2002;156:1223-1229.
Background In the fall of 1998, North Carolina implemented its State Children Health Insurance Program, North Carolina Health Choice for Children (NCHC). This stand-alone, fee-for-service program quickly enrolled large numbers of children and has been considered one of the State Children Health Insurance Program success stories.
Objective To explore the perceptions of parents of children enrolled in NCHC regarding their children's access to health care services before and after enrollment in the NCHC.
Design and Setting Qualitative and quantitative data analyses are combined to assess program effectiveness. Two waves of surveys were fielded. A baseline survey asked parents of children newly enrolled in NCHC questions about their child's health experiences before enrollment in NCHC. Parents who responded with baseline data were resurveyed 1 year later to collect information on their child's experiences while insured by NCHC.
Participants Parents of 987 children newly enrolled in NCHC in the summer of 2000, randomly chosen within 3 age group strata.
Results The NCHC has been successful in improving access to health care for low-income children. Parents reported that the program helped make health services financially accessible to their children, enabling them to get needed physician's care, eyeglasses, or prescription drugs. A significantly higher percentage of children received care in the private sector, increasing from 62% to 75% for well-child care visits and 67% to 78% for acute care. The percentage of children with unmet medical needs dropped significantly from 20% to just 2% after enrollment in NCHC. The improvement in access to care is much more striking for the older age groups and for children who were uninsured prior to NCHC enrollment (rather than those who graduated from Medicaid into the program). Despite these gains, there are still substantial numbers of children who are not receiving age-appropriate well-child care.
Conclusion The NCHC has successfully improved access to care for its enrollees.
From the Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.
RELATED ARTICLE
The State Children's Health Insurance Program: Effective but Vulnerable
Paul H. Wise
Arch Pediatr Adolesc Med. 2002;156(12):1175-1176.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
SCHIP At A Crossroads: Experiences To Date And Challenges Ahead
Kenney and Yee
Health Aff (Millwood) 2007;26:356-369.
ABSTRACT
| FULL TEXT
Improved Asthma Care After Enrollment in the State Children's Health Insurance Program in New York
Szilagyi et al.
Pediatrics 2006;117:486-496.
ABSTRACT
| FULL TEXT
Changes in Access, Utilization, and Quality of Care After Enrollment Into a State Child Health Insurance Plan
Kempe et al.
Pediatrics 2005;115:364-371.
ABSTRACT
| FULL TEXT
Planning the Next Wave of SCHIP Research
Davis
Pediatrics 2005;115:492-494.
FULL TEXT
Improved Access and Quality of Care After Enrollment in the New York State Children's Health Insurance Program (SCHIP)
Szilagyi et al.
Pediatrics 2004;113:e395-e404.
ABSTRACT
| FULL TEXT
Behind Schedule: Improving Access to Care for Children One Practice at a Time
Randolph et al.
Pediatrics 2004;113:e230-237.
ABSTRACT
| FULL TEXT
The State Children's Health Insurance Program: Effective but Vulnerable
Wise
Arch Pediatr Adolesc Med 2002;156:1175-1176.
FULL TEXT
|
