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参加儿童健康保险计划(SCHIP)的青少年之前的医疗保健经历。

Prior health care experiences of adolescents who enroll in SCHIP.

作者信息

Klein Jonathan D, Shenkman Elizabeth, Brach Cindy, Shone Laura P, Col Jana, Schaffer Virginia A, Dick Andrew W, VanLandeghem Karen, Szilagyi Peter G

机构信息

Department of Pediatrics, University of Rochester School of Medicine and Dentistry, USA.

出版信息

J Health Care Poor Underserved. 2006 Nov;17(4):789-807. doi: 10.1353/hpu.2006.0127.

Abstract

The State Children's Health Insurance Program (SCHIP) was designed to provide health insurance to low-income children and adolescents. Little is known about prior access to care and health care experiences of new SCHIP enrollees. We surveyed Florida and New York new adolescent SCHIP enrollees about their health status, prior health care utilization, access, and unmet needs. Most enrollees were younger (ages 12-16 years), Black or Hispanic, lived in poverty, and were without health insurance the year before SCHIP. Most had a usual source of care (USC) prior to enrollment; Blacks and Hispanics were less likely than Whites to have had a USC. Although 69% of Florida and 80% of New York adolescents reported seeing a physician the year before enrollment, 24% and 40%, respectively, reported unmet health care needs. Only 32% of Florida and 40% of the New York adolescents who were surveyed reported ever having met privately with their clinicians. Many new SCHIP enrollees report unmet needs, disparities in access, and sub-optimal care prior to enrollment. Adolescents' needs should be considered in SCHIP program and quality assurance efforts.

摘要

国家儿童健康保险计划(SCHIP)旨在为低收入儿童和青少年提供医疗保险。对于新加入SCHIP的参保者此前获得医疗服务的情况和医疗保健经历,人们知之甚少。我们对佛罗里达州和纽约州新加入SCHIP的青少年参保者进行了调查,了解他们的健康状况、此前的医疗保健利用情况、获得医疗服务的机会以及未满足的需求。大多数参保者年龄较小(12至16岁),为黑人或西班牙裔,生活贫困,在加入SCHIP的前一年没有医疗保险。大多数人在参保前有常规的医疗服务来源(USC);黑人和西班牙裔拥有USC的可能性低于白人。尽管佛罗里达州69%的青少年和纽约州80%的青少年报告在参保前一年看过医生,但分别有24%和40%的人报告有未满足的医疗保健需求。在接受调查的佛罗里达州青少年中,只有32%的人以及纽约州青少年中只有40%的人报告曾与他们的临床医生私下会面。许多新加入SCHIP的参保者报告在参保前有未满足的需求、获得医疗服务的机会存在差异以及医疗服务不够理想。在SCHIP计划和质量保证工作中应考虑青少年的需求。

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