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Utilization of health services by poor children since advent of medicaid
Insights
Medicaid increased health service use by poor children, but data suggest a paradoxical effect. Publicly sponsored systems saw more use, while private provider visits decreased for this group.
Area of Science:
- Health Services Research
- Pediatric Health
- Public Health Policy
Background:
- Utilization of health services by impoverished children has risen since the introduction of Medicaid in 1966.
- Despite increased visits, the full healthcare needs of poor children remain unmet due to greater service requirements.
- Existing data are insufficient to fully detail the patterns of this increased healthcare utilization.
Purpose of the Study:
- To analyze the impact of Medicaid on healthcare utilization patterns among poor children.
- To investigate whether Medicaid has successfully integrated poor children into mainstream healthcare provider systems.
- To examine the potential paradoxical effects of Medicaid on the utilization of public versus private healthcare providers by low-income children.
Main Methods:
- Analysis of national and local survey data on healthcare utilization.
- Comparison of healthcare access and service use between poor and non-poor children.
- Examination of trends in the use of public versus private healthcare providers.
Main Results:
- Poor children now visit medical providers at rates similar to non-poor children.
- Medicaid may have paradoxically led to a decrease in the utilization of private medical providers by poor children.
- There has been a proportional increase in the use of publicly sponsored healthcare systems by poor children.
Conclusions:
- While Medicaid has increased overall health service utilization for poor children, it may not have achieved full integration into private healthcare systems.
- Further research is needed to fully understand the mechanisms and consequences of Medicaid's impact on provider choice for low-income children.
- The findings suggest a complex and potentially unintended shift in healthcare seeking behavior among the pediatric population eligible for Medicaid.
Abstract:
Many sources of data confirm that utilization of health services by poor children has increased since the advent of Medicaid in 1966. Poor children make approximately the same number of visits to medical provides each year as do non-poor children. Considering the greater need for services among poor children, few suggest that their full need is met. Available data are not entirely adequate to document how or where the increased utilization has occurred. The Medicaid legislation appeared to presume that poor children would be "mainstreamed" into the same provider systems that are used by the non-poor. Data from national and local surveys are cited in support of the possibility that Medicaid has in fact had a paradoxical effect, proportionately increasing publicly sponsored provider systems, and proportionately decreasing poor children's utilization of private medical providers.