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Changes in access, utilization, and quality of care after enrollment into a state child health insurance plan

Allison Kempe1, Brenda L Beaty, Lori A Crane

  • 1Department of Pediatrics, University of Colorado Health Sciences Center, and the Children's Outcomes Research Program, Children's Hospital, Denver, Colorado, USA. kempe.allison@tchden.org

Pediatrics
|February 3, 2005
PubMed

Insights

Enrollment in Colorado

Area of Science:

  • Pediatric Health Services Research
  • Public Health Policy
  • Health Services Administration

Background:

  • Limited data exist on the impact of State Children's Health Insurance Programs (SCHIP) on pediatric health outcomes.
  • Colorado's Child Health Plan Plus (CHP+) is a non-Medicaid SCHIP initiated in April 1998.

Purpose of the Study:

  • To evaluate the effect of CHP+ enrollment on children's access to care, healthcare utilization, and quality of care.
  • To compare reported outcomes in the year preceding and the first year following CHP+ enrollment.

Main Methods:

  • Telephone interviews were conducted with 480 randomly selected families enrolled in CHP+.
  • Data were collected two months post-enrollment and again one year later.
  • Generalized linear models were used to analyze the impact of enrollment, controlling for demographic and insurance factors.

Main Results:

  • Families reported significantly improved access to routine, sick, and specialty care, with increased ability to see providers promptly.
  • Unmet medical needs decreased across prescription medications, mental health services, dental care, and vision care.
  • While routine care utilization increased, emergency department visits and hospitalizations did not, indicating efficient care seeking.
  • Perceived quality of care rated as "best" significantly increased post-enrollment.

Conclusions:

  • CHP+ enrollment led to substantial improvements in perceived access to care and reductions in unmet medical needs for children.
  • The program demonstrated effective care management, with no increase in emergency or inpatient utilization.
  • Overall quality of care was perceived as improved by families after enrolling in CHP+.
Abstract

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