Health Policy Center, The Urban Institute, Washington, DC 20037, USA.
Med Care Res Rev. 2012 Aug;69(4):372-96. doi: 10.1177/1077558712437245. Epub 2012 Mar 26.
This article reviews findings from 38 rigorous studies published in the peer-reviewed literature of the impact of the Medicaid/Children's Health Insurance Program (CHIP) expansions on children. There is strong evidence for increases in enrollment in public programs and reductions in uninsurance following eligibility expansions. Medicaid enrollment continued to increase during the CHIP era (a "spillover effect"). Evidence for improved access to and use of services, particularly for dental care, is also very strong. There are fewer studies of health status impacts, and the evidence is mixed. There is a very wide range in the size of effects estimated in the studies reviewed because of the methods used and the populations studied. The review identifies several important research gaps on this topic, particularly the small number of studies of the effects on health status. Both research methods and findings from the child expansions can provide insights for evaluating the coming expansions for adults under the Affordable Care Act.
这篇文章综述了同行评议文献中 38 项关于医疗补助/儿童健康保险计划（CHIP）扩面对于儿童影响的严谨研究结果。有强有力的证据表明，在资格扩大后，公共计划的入保率增加，未参保率降低。在 CHIP 时代，医疗补助的入保人数持续增加（“溢出效应”）。在获得和使用服务方面，特别是在牙科护理方面，证据也非常有力。关于健康状况影响的研究较少，证据也不一致。由于所使用的方法和研究的人群不同，审查中估计的效果大小差异很大。该综述确定了该主题的几个重要研究空白，特别是关于对健康状况影响的研究数量较少。儿童扩面的研究方法和结果都可以为评估平价医疗法案下即将进行的成人扩面提供参考。
