Clemans-Cope Lisa, Kenney Genevieve, Waidmann Timothy, Huntress Michael, Anderson Nathaniel
Health Policy Center, The Urban Institute, Washington, DC.
Health Policy Center, The Urban Institute, Washington, DC.
Acad Pediatr. 2015 May-Jun;15(3 Suppl):S71-7. doi: 10.1016/j.acap.2015.02.007. Epub 2015 Mar 29.
We examine how access to care and care experiences under the Children's Health Insurance Program (CHIP) compared to private coverage and being uninsured in 10 states.
We report on findings from a 2012 survey of CHIP enrollees in 10 states. We examined a range of health care access and use measures among CHIP enrollees. Comparisons of the experiences of established CHIP enrollees to the experiences of uninsured and privately insured children were used to estimate differences in children's health care.
Children with CHIP coverage had substantially better access to care across a range of outcomes, other things being equal, particularly compared to those with no coverage. Compared to being uninsured, CHIP enrollees were more likely to have specialty and mental health visits and to receive prescription drugs; and their parents were much more likely to feel confident in meeting the child's health care needs and were less likely to have trouble finding providers. CHIP enrollees were less likely to have unmet needs, but 1 in 4 had at least 1 unmet need. Compared to being privately insured, CHIP enrollees had generally similar health care use and unmet needs. Additionally, CHIP enrollees had lower financial burden related to their health care needs. The findings were generally robust with respect to alternative specifications and subgroup analyses, and they corroborated findings of previous studies.
Enrolling more of the uninsured children who are eligible for CHIP improved their access to a range of care, including specialty and mental health services, and reduced the financial burden of meeting their health care needs; however, we found room for improvement in CHIP enrollees' access to care.
我们研究了在10个州，儿童健康保险计划（CHIP）下的医疗服务可及性和就医体验与私人保险及未参保情况相比如何。
我们报告了2012年对10个州CHIP参保者的调查结果。我们研究了CHIP参保者一系列的医疗服务可及性和使用指标。将现有CHIP参保者的就医体验与未参保和参加私人保险儿童的就医体验进行比较，以估计儿童医疗服务方面的差异。
在其他条件相同的情况下，参加CHIP保险的儿童在一系列指标上获得医疗服务的情况明显更好，尤其是与未参保儿童相比。与未参保儿童相比，CHIP参保者更有可能看专科医生和精神科医生并接受处方药治疗；他们的父母更有可能对满足孩子的医疗需求充满信心，而且在寻找医疗服务提供者方面遇到困难的可能性更小。CHIP参保者未满足需求的可能性较小，但四分之一的参保者至少有一项未满足的需求。与参加私人保险的儿童相比，CHIP参保者在医疗服务使用和未满足需求方面总体相似。此外，CHIP参保者在医疗需求方面的经济负担更低。这些发现对于替代规范和亚组分析而言总体上是稳健的，并且证实了先前研究的结果。
让更多符合条件的未参保儿童加入CHIP提高了他们获得一系列医疗服务的机会，包括专科和精神健康服务，并减轻了满足其医疗需求的经济负担；然而，我们发现CHIP参保者在获得医疗服务方面仍有改进空间。
