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Related Experiment Videos

Context or composition: what explains variation in SCHIP disenrollment?

Julie A Phillips1, Jane E Miller, Joel C Cantor

  • 1Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ 08901, USA.

Health Services Research
|July 3, 2004
PubMed
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State Children's Health Insurance Program (SCHIP) disenrollment is higher for families with cost-sharing, black families, and single-child households. Physician and population density in counties also influence SCHIP retention rates.

Area of Science:

  • Health Services Research
  • Public Health Policy
  • Health Disparities

Background:

  • State Children's Health Insurance Program (SCHIP) plays a crucial role in providing health coverage to low-income children.
  • Understanding factors influencing disenrollment from SCHIP is vital for ensuring program continuity and effectiveness.
  • Variation in SCHIP disenrollment rates exists across families and geographic contexts.

Purpose of the Study:

  • To determine the relative impact of family and contextual characteristics on SCHIP disenrollment rates.
  • To assess whether contextual factors explain observed family-level disenrollment patterns.

Main Methods:

  • Utilized secondary data from 24,628 families enrolled in New Jersey's SCHIP program (NJ KidCare).
  • Incorporated county-level data from the Area Resource File, Census, and NJ FamilyCare provider roster.

Related Experiment Videos

  • Employed a multilevel discrete-time-hazards model to analyze SCHIP disenrollment.

    • Main Results:

    • Families in plans with cost-sharing, black families, and those with a single enrolled child exhibited higher disenrollment rates.
    • Disenrollment rates for black families were lower in counties with a higher proportion of black physicians.
    • Intercounty variation in disenrollment was partly explained by these family characteristics, with remaining variation attributed to physician or population density.

    Conclusions:

    • Targeted attention to black families and high-disenrollment counties may improve SCHIP retention.
    • Addressing cultural disparities between physicians and patients and optimizing medical provider distribution could reduce disenrollment.
    • Policy interventions should consider both individual family attributes and broader contextual influences on program participation.