医疗补助计划覆盖儿童的高额医疗保健支出持续存在。

Persistence of high health care expenditures among children in Medicaid.

作者信息

Shenkman Elizabeth, Knapp Caprice, Sappington David, Vogel Bruce, Schatz Des

机构信息

University of Florida.

出版信息

Med Care Res Rev. 2007 Jun;64(3):304-30. doi: 10.1177/1077558707299864.

DOI:10.1177/1077558707299864

PMID:17507460

Abstract

Cross-sectional studies show that a small percentage of children consume a large portion of the health care dollar. However, little is known about the persistence of high health care expenditures among children enrolled in Medicaid health maintenance organizations (HMOs) or in primary care case management (PCCM) programs. This study found substantial expenditure persistence during a 3-year period. Among Temporary Aid to Needy Families (TANF) children in HMOs in the top 10 percent of the expenditure distribution in 2003, 34 percent remained in the top 10 percent in 2004, and 23 percent remained in the top 10 percent in 2005. Similar patterns were observed for TANF children in the PCCM. Expenditure persistence varied based on the enrollees' enabling and need characteristics, providing opportunities to identify children with high health care expenditures who may benefit from care coordination.

摘要

横断面研究表明，一小部分儿童消耗了大部分的医疗保健费用。然而，对于参加医疗补助健康维护组织（HMOs）或初级保健病例管理（PCCM）项目的儿童中高医疗保健支出的持续性，人们了解甚少。本研究发现，在三年期间存在大量的支出持续性。在2003年支出分布处于前10%的HMOs中的贫困家庭临时援助（TANF）儿童中，34%在2004年仍处于前10%，23%在2005年仍处于前10%。PCCM中的TANF儿童也观察到类似模式。支出持续性因参保人的能力和需求特征而异，这为识别可能从护理协调中受益的高医疗保健支出儿童提供了机会。