Shattuck Paul T, Grosse Scott, Parish Susan, Bier Daniel
Brown School of Social Work, Washington University, 1 Brookings Dr., Campus Box 1196, St. Louis, MO 63130, USA.
Psychiatr Serv. 2009 Apr;60(4):549-52. doi: 10.1176/ps.2009.60.4.549.
The study examined utilization of Wisconsin's Medicaid funding for autism intervention before and after a major shift in program administration.
Medicaid enrollment data were analyzed for 1,822 children with autism from 2000 through 2006, as were geocoded demographic data and decennial census data. Enrollees' data were compared with demographic data for Wisconsin's general population.
Compared with averages for all Wisconsin families, new Medicaid enrollees in 2000 were more likely to be from census tracts with a high proportion of white families with high socioeconomic status. These disparities decreased by 2006, two years after a change from a Medicaid fee-for-service structure to a Medicaid home- and community-based services waiver.
As more states consider carve-out benefits for children with autism, close attention needs to be paid to the potential for disparities and the influence of mode of administration on utilization.
本研究考察了威斯康星州医疗补助资金在项目管理发生重大转变前后用于自闭症干预的情况。
分析了2000年至2006年1822名自闭症儿童的医疗补助登记数据,以及地理编码的人口统计数据和十年一次的人口普查数据。将登记者的数据与威斯康星州普通人群的人口统计数据进行比较。
与威斯康星州所有家庭的平均水平相比,2000年新加入医疗补助计划的人更有可能来自社会经济地位较高的白人家庭比例较高的普查区。在从医疗补助按服务收费结构转变为基于家庭和社区的医疗补助豁免服务两年后的2006年,这些差距有所缩小。
随着越来越多的州考虑为自闭症儿童设立专项福利,需要密切关注差距产生的可能性以及管理模式对使用情况的影响。