Department of Epidemiology and Community Health, School of Health Sciences & Practice, New York Medical College, NY 10595, USA. ChiaChing
Health Policy. 2011 Jan;99(1):72-82. doi: 10.1016/j.healthpol.2010.07.012. Epub 2010 Aug 11.
State Children's Health Insurance Program (SCHIP) in the USA plays a critical role in healthcare service utilization. This study assesses children's needs for healthcare services among the variations of SCHIP.
This study applies the PRECEDE-PROCEED behavioral model to analyze the behavior of children with healthcare needs and unmet healthcare needs by using the National Survey of Children with Special Healthcare Needs of the USA.
Children who were previously under a Medicaid program are apt to enroll in SCHIP programs. SCHIP children with healthcare needs are more likely than comparable non-SCHIP children to use hospital outpatient departments instead of using doctors' offices and health centers. Children under the SCHIP single and SCHIP combination programs are more likely to use doctors' offices and health centers than those in the Medicaid expansion program. SCHIP combination or SCHIP Medicaid expansion states are significantly less likely to have unmet healthcare needs than children in SCHIP single states.
Medicaid has a significant impact on the SCHIP program. There is a substitution of healthcare service facilities between hospital outpatient departments and either the doctors' offices or health centers.
美国的儿童健康保险计划（SCHIP）在医疗服务利用方面发挥着关键作用。本研究评估了 SCHIP 计划中不同情况下儿童对医疗服务的需求。
本研究应用 PRECEDE-PROCEED 行为模式，通过使用美国全国特殊医疗保健需求儿童调查，分析有医疗需求和未满足医疗需求的儿童的行为。
以前参加医疗补助计划的儿童更容易参加 SCHIP 计划。有医疗需求的 SCHIP 儿童比可比的非 SCHIP 儿童更有可能使用医院门诊部门，而不是医生办公室和健康中心。参加 SCHIP 单一计划和 SCHIP 组合计划的儿童比参加医疗补助扩大计划的儿童更有可能使用医生办公室和健康中心。参加 SCHIP 组合或 SCHIP 医疗补助扩大计划的州，未满足医疗需求的儿童明显少于参加 SCHIP 单一计划的州。
医疗补助对 SCHIP 计划有重大影响。医院门诊部门和医生办公室或健康中心之间的医疗服务设施存在替代关系。
