Mulvihill Beverly A, Obuseh Francis A, Caldwell Cathy
Department of Maternal and Child Health RPHB 320, School of Public Health, University of Alabama at Birmingham, 1530 3rd Avenue South, Birmingham, AL 35294-0022, USA.
Matern Child Health J. 2008 Mar;12(2):260-5. doi: 10.1007/s10995-007-0236-x. Epub 2007 Jun 6.
This study's purpose was to understand how experiences with and perceptions of the health care plan characteristics influence provider satisfaction with a State Children's Health Insurance Program (SCHIP).
Physicians and other health care providers participating in one program (ALL Kids) were mailed a survey (n = 500). Pediatricians were the most likely to return the survey. We used frequencies, chi-square and logistic regression analysis to explore relationships.
The odds of being less satisfied with the program among providers who perceived that reimbursement in the ALL Kids program was less compared to private insurance were almost 7 times (OR = 6.81; 95% CI = (1.88-24.73)) greater than for those who perceived that reimbursement was more or the same in ALL Kids. Likewise, respondents who perceived that All Kids families were less likely than families with private insurance to return for follow-up visits were less satisfied with ALL Kids (OR = 17.42; 95% CI = (1.85-164.70)).
The stigma of SCHIP may be less than that often associated with Medicaid; however, this investigation should be considered with others that have identified barriers for provider's participation. This study indicates that provider satisfaction is related to their perceptions of SCHIP policies and families, though it does not tell us what factors might contribute to this perception, such as, previous experience with public insurance (Medicaid) and publicly insured patients. Increasing reimbursement rates may not address perceptions that affect provider views of publicly-supported health plans and the participating families.
本研究旨在了解医疗保健计划特征的体验和认知如何影响医疗服务提供者对州儿童健康保险计划(SCHIP)的满意度。
向参与一个项目(ALL Kids)的医生和其他医疗服务提供者邮寄了一份调查问卷(n = 500)。儿科医生最有可能回复该调查问卷。我们使用频率、卡方检验和逻辑回归分析来探究其中的关系。
与私人保险相比,认为ALL Kids项目报销较少的医疗服务提供者对该项目不满意的几率几乎是那些认为ALL Kids项目报销较多或相同的医疗服务提供者的7倍(OR = 6.81;95% CI = (1.88 - 24.73))。同样,认为ALL Kids家庭比有私人保险的家庭复诊可能性更小的受访者对ALL Kids项目的满意度更低(OR = 17.42;95% CI = (1.85 - 164.70))。
SCHIP的污名可能比通常与医疗补助相关的污名要小;然而,本调查应与其他已确定医疗服务提供者参与障碍的调查一并考虑。本研究表明,医疗服务提供者的满意度与他们对SCHIP政策和家庭的认知有关,尽管它没有告诉我们哪些因素可能导致这种认知,比如之前与公共保险(医疗补助)和参保的公共病人打交道的经历。提高报销率可能无法解决影响医疗服务提供者对公共支持的健康计划和参保家庭看法的认知问题。