The State Children's Health Insurance Program (SCHIP) was implemented in 1998, providing new funds for states to cover uninsured children. This study examines the relationship between SCHIP implementation in California and hospitalizations for ambulatory care sensitive conditions (ACSCs), an indicator of primary care access and quality. We use administrative SCHIP enrollment records for urban California counties, linked with corresponding rates of hospitalization for seven ACSCs among children ages 1-18 for 1996-2000. Results from multivariate regression models indicate that increases of 1 percentage point in SCHIP enrollment are associated with reductions of 0.42 ACSC admissions per 100,000 children age 1-18 (p = 0.009). Models that use lagged effects of SCHIP enrollment indicate an even stronger relationship. These are population-level relationships, and translate to much larger effects on the specific population subset that enrolled in SCHIP. These results suggest a strong beneficial effect of SCHIP on primary care among the children covered.
"Several other studies that observe declining rates of hospital visits for ambulatory care sensitive conditions at the same time of insurance expansions have concluded that insurance expansions can reduce use of hospital care for these conditions (Bermudez et al. 2005; Cousineau et al. 2007). These prior studies have examined hospital stays rather than ED use and in some cases examine patterns for all publicly insured children rather than only those directly enrolled in the expansion. "
"However, rising healthcare costs have threatened children with special healthcare needs among the heterogeneous population (Szilagyi et al., 2003; Dick et al., 2004; Mayer, Skinner & Slifkin, 2004). Eisert and Gabow (2002), Bermudez and Baker (2005), and Cunningham (2006) found that children of the Child Health Insurance Program are associated with a reduction in the need for ambulatory care services. SCHIP has another important role; mitigating the problems of the nation's low-income, uninsured children (Carroll, Corman, Noonan, & Reichman, 2007). "
[Show abstract][Hide abstract] ABSTRACT: The Balanced Budget Act of 1997 established the State Children’s Health Insurance Program (SCHIP), which makes health insurance available to children under the age of eighteen who are members of low income families that do not qualify for Medicaid. The recent development in the government outreach strategies of the SCHIP program has contributed to reduce the disparity in healthcare service accessibility to children.
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