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Health care costs associated with child maltreatment: impact on medicaid
Curtis Florence1, Derek S Brown, Xiangming Fang
1Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Analysis, Research and Practice Integration, Atlanta, Georgia 30341, USA. cflorence@cdc.gov
Insights
Child maltreatment significantly increases Medicaid costs, with affected children incurring over $2600 more in annual expenditures. Prevention programs could help offset these substantial financial burdens on the healthcare system.
Area of Science:
- Public Health
- Health Economics
- Child Welfare
Background:
- Child maltreatment represents a significant public health issue with considerable economic consequences.
- Medicaid expenditures are a major component of healthcare spending for children in the United States.
Purpose of the Study:
- To quantify the additional financial burden child maltreatment places on the Medicaid program.
- To estimate the per-child increase in Medicaid expenditures associated with maltreatment or risk of maltreatment.
Main Methods:
- Utilized data from the National Survey of Child and Adolescent Well-Being and Medicaid Analytic Extract (MAX) for matched child populations.
- Employed propensity score matching to establish a comparable control group from MAX data.
- Applied two-part regression models to determine the impact of child maltreatment on Medicaid spending.
Main Results:
- Children identified as maltreated or at risk incurred average annual Medicaid expenditures exceeding $2600 more than unexposed children.
- These increased expenditures associated with child maltreatment constituted approximately 9% of total Medicaid spending for children.
- The study highlights a direct correlation between child maltreatment and elevated healthcare costs within the Medicaid system.
Conclusions:
- Child maltreatment imposes a substantial financial burden on the Medicaid system, underscoring the economic impact of child abuse and neglect.
- Investing in evidence-based child maltreatment prevention strategies could lead to significant cost savings for Medicaid.
- Addressing child maltreatment is crucial not only for child well-being but also for fiscal responsibility within public health programs.
Objective:
To estimate the increased Medicaid expenditures associated with child maltreatment.
Methods:
Data on child maltreatment were collected from the National Survey of Child and Adolescent Well-Being, a nationally representative sample of cases investigated or assessed by local Child Protective Services agencies between October 1999 and December 2000. Medicaid claims data for 2000 to 2003 were obtained from the Medicaid Analytic Extract (MAX). Children from the National Survey of Child and Adolescent Well-Being who had Medicaid were matched to the MAX data by Social Security number or birthdate, gender, and zip code. Propensity score matching was used to select a comparison group from the MAX data. Two-part regression models were used to estimate the impact of child maltreatment on expenditures. Data with individual identifiers were obtained under confidentiality agreements with the collecting agencies.
Results:
Children who were identified as maltreated or as being at risk of maltreatment incurred, on average, Medicaid expenditures that were >$2600 higher per year compared with children not so identified. This finding accounted for ~9% of all Medicaid expenditures for children.
Conclusions:
Child maltreatment imposes a substantial financial burden on the Medicaid system. These expenses could be partially offset by increased investment in child maltreatment prevention.
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