Barry Colleen L, Busch Susan H
Department of Epidemiology and Public Health, Yale University School of Medicine, Division of Health Policy and Administration, 60 College Street, New Haven, CT 06520, USA.
Health Serv Res. 2007 Jun;42(3 Pt 1):1061-84. doi: 10.1111/j.1475-6773.2006.00650.x.
To study the financial impact of state parity laws on families of children in need of mental health services.
Privately insured families in the 2000 State and Local Area Integrated Telephone Survey National Survey of Children with Special Health Care Needs (CSHCN) (N=38,856).
We examine whether state parity laws reduce the financial burden on families of children with mental health conditions. We use instrumental variable estimation controlling for detailed information on a child's health and functional impairment. We compare those in parity and nonparity states and those needing mental health care with other CSHCN.
Multivariate regression results indicate that living in a parity state significantly reduced the financial burden on families of children with mental health care needs. Specifically, the likelihood of a child's annual out-of-pocket (OOP) health care spending exceeding $1,000 was significantly lower among families of children needing mental health care living in parity states compared with those in nonparity states. Families with children needing mental health care in parity states were also more likely to view OOP spending as reasonable compared with those in nonparity states. Likewise, living in a parity state significantly lowered the likelihood of a family reporting that a child's health needs caused financial problems. The likelihood of reports that additional income was needed to finance a child's care was also lower among families with mentally ill children living in parity states. However, we detect no significant difference among residents of parity and nonparity states in receipt of needed mental health care.
These results indicate that state parity laws are providing important economic benefits to families of mentally ill children undetected in prior research.
研究州平价法对需要心理健康服务的儿童家庭的经济影响。
2000年州和地方综合电话调查中享有私人保险的家庭,全国特殊医疗需求儿童调查(CSHCN)(N = 38,856)。
我们研究州平价法是否减轻了患有心理健康问题儿童家庭的经济负担。我们使用工具变量估计法,并控制有关儿童健康和功能损害的详细信息。我们比较了处于平价和非平价状态的家庭,以及需要心理健康护理的家庭与其他特殊医疗需求儿童。
多元回归结果表明,生活在平价州显著减轻了有心理健康护理需求儿童家庭的经济负担。具体而言,与非平价州相比,生活在平价州的有心理健康护理需求儿童家庭中,孩子年度自付医疗费用超过1000美元的可能性显著更低。与非平价州的家庭相比,平价州中有心理健康护理需求儿童的家庭也更有可能认为自付费用是合理的。同样,生活在平价州显著降低了家庭报告孩子的健康需求导致经济问题的可能性。生活在平价州的患有精神疾病儿童的家庭中,报告需要额外收入来支付孩子护理费用的可能性也更低。然而,我们发现平价州和非平价州的居民在获得所需心理健康护理方面没有显著差异。
这些结果表明,州平价法正在为患有精神疾病儿童的家庭提供重要的经济利益,而这在先前的研究中未被发现。