Smith Kimberly V, Dye Claire
Mathematica Policy Research, Princeton, NJ.
Mathematica Policy Research, Princeton, NJ.
Acad Pediatr. 2015 May-Jun;15(3 Suppl):S64-70. doi: 10.1016/j.acap.2015.02.012.
To examine differences in primary care outcomes under the Children's Health Insurance Program (CHIP) compared to private coverage and being uninsured in 10 states.
We used data from a survey of parents of recent and established CHIP enrollees conducted from January 2012 through March 2013. We compared the primary care experiences of established CHIP enrollees to the preenrollment experiences of previously uninsured and privately insured recent CHIP enrollees to estimate differences in care outcomes.
Parents of 4142 recent enrollees and 5518 established enrollees responded to the survey (response rates were 46% for recent enrollees and 51% for established enrollees). Compared to being uninsured, CHIP enrollees were more likely to have a well-child visit, receive a range of preventive care services, and have patient-centered care experiences. They were also more likely than uninsured children to have a regular source of care or provider, an easy time making appointments, and shorter wait times for those appointments. Relative to privately insured children, CHIP enrollees received preventive care services at similar rates and to be more likely to receive effective care coordination services. However, CHIP enrollees were less likely than privately insured children to have a regular source of care or provider and nighttime and weekend access to a usual source of care.
CHIP continues to provide high levels of access to primary care, especially compared to uninsured children, and to provide benefits comparable to private insurance.
研究儿童健康保险计划(CHIP)覆盖下的初级保健结果与10个州的私人保险及未参保情况相比存在的差异。
我们使用了2012年1月至2013年3月对近期加入和已加入CHIP的参保者家长进行的一项调查数据。我们将已加入CHIP的参保者的初级保健经历与之前未参保和近期参保的私人保险参保者参保前的经历进行比较,以估计保健结果的差异。
4142名近期参保者和5518名已参保者的家长回复了调查(近期参保者的回复率为46%,已参保者的回复率为51%)。与未参保相比,CHIP参保者更有可能进行健康儿童检查、接受一系列预防保健服务,并获得以患者为中心的保健体验。他们也比未参保儿童更有可能有固定的医疗服务来源或医疗服务提供者,预约方便,预约等待时间更短。相对于有私人保险的儿童,CHIP参保者接受预防保健服务的比例相似,且更有可能接受有效的保健协调服务。然而,CHIP参保者比有私人保险的儿童更不可能有固定的医疗服务来源或医疗服务提供者,也不太可能在夜间和周末获得常规医疗服务来源。
CHIP继续提供高水平的初级保健服务,尤其是与未参保儿童相比,并且提供与私人保险相当的福利。