University of North Carolina, School of Social Work, 325 Pittsboro Street, CB 3550, Chapel Hill, NC 27599-3550, United States.
Soc Sci Med. 2010 May;70(9):1263-70. doi: 10.1016/j.socscimed.2009.12.031. Epub 2010 Feb 12.
This study examines whether the US public health insurance program Medicaid suppresses racial disparities in parental identification of service needs of their children with special health care needs (CSHCN). We analyze data from the 2001 US National Survey of CSHCN (n = 14,167 children). We examine three outcomes which were parental identification of (a) the child's need for professional care coordination, (b) the child's need for mental health services, and (c) the family's need for mental health services. A suppression analysis, which is a form of mediation analysis, was conducted. Our results show a disparity, reflected in a negative direct effect of race for all three outcomes: Black parents of CSHCN are less likely to report a need for services than White parents of CSHCN and Medicaid coverage was associated with reduced racial disparities in reporting the need for services. These analyses suggest receipt of Medicaid is associated with a suppression of racial disparities in reported need for services.
本研究考察了美国公共医疗保险计划 Medicaid 是否能减少特殊医疗需求儿童（CSHCN）父母识别其子女服务需求方面的种族差异。我们分析了来自 2001 年美国 CSHCN 全国调查的数据（n=14167 名儿童）。我们考察了三个结果，即父母识别（a）孩子需要专业的医疗协调服务、（b）孩子需要心理健康服务、（c）家庭需要心理健康服务的情况。我们进行了抑制分析，这是一种中介分析形式。我们的结果显示出一种差异，反映在所有三个结果中种族的负向直接效应：CSHCN 的黑人父母比 CSHCN 的白人父母更不可能报告服务需求，而 Medicaid 覆盖与报告服务需求的种族差异减少有关。这些分析表明，获得 Medicaid 与报告服务需求的种族差异抑制有关。
