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Tracking the State Children's Health Insurance Program with hospital data: national baselines, state variations, and

B Friedman, J Jee, C Steiner

    Medical Care Research and Review : MCRR
    |December 10, 1999
    PubMed

    Insights

    Hospital data reveals a significant rise in ambulatory care sensitive (ACS) admissions for children with Medicaid or self-pay insurance from 1990-1995. This trend occurred as admissions for other insured children decreased.

    Area of Science:

    • Health Services Research
    • Pediatric Healthcare Policy
    • Public Health Analytics

    Background:

    • State and federal agencies monitor the impact of the State Children's Health Insurance Program (CHIP) on children's healthcare.
    • Ambulatory care sensitive (ACS) hospital admissions serve as a key indicator for evaluating healthcare access and quality for children.

    Purpose of the Study:

    • To establish baseline rates of ACS admissions prior to CHIP implementation.
    • To analyze trends and variations in ACS admissions across different states.
    • To investigate shifts in ACS admission rates among various insurance groups.

    Main Methods:

    • Utilized hospital data from 19 states to calculate ACS admission rates.
    • Analyzed trends in ACS admissions for the period preceding the CHIP program.
    • Compared admission rates across different insurance categories (self-pay, Medicaid, other insured).

    Main Results:

    • A notable increase in ACS admissions was observed for children enrolled in Medicaid or with self-pay insurance between 1990 and 1995.
    • Conversely, ACS admission rates for children with other forms of insurance declined by over 33% during the same period.
    • Cross-state comparisons indicated a correlation between higher asthma admission rates and a greater proportion of self-pay plus Medicaid-enrolled cases.

    Conclusions:

    • The pre-CHIP era showed diverging trends in ACS hospitalizations based on insurance status.
    • Findings highlight potential disparities in healthcare access and management for vulnerable pediatric populations.
    • Further research is warranted to understand the drivers behind these observed admission rate changes.

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