Are there differential effects of managed care on publicly insured children with chronic health conditions?

被引：4

作者：

Davidoff, Amy ^{[1
]}

Hill, Ian ^{[2
]}

Courtot, Brigette ^{[2
]}

Adams, Emerald ^{[3
]}

机构：

[1] Univ Maryland, Baltimore, MD 21201 USA

[2] Natl Womens Law Ctr, Washington, DC USA

[3] Univ Calif Berkeley, Berkeley, CA 94720 USA

来源：

MEDICAL CARE RESEARCH AND REVIEW | 2008年 / 65卷 / 03期

关键词：

health insurance; managed care; chronic conditions; access;

D O I：

10.1177/1077558707312492

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

The authors use variation across states and over time in managed care (MC) programs for publicly insured children to examine whether effects differ for children with chronic health conditions (CWCHC) and those without. The authors pool data from the 1997 to 2002 National Health Interview Survey and link county, year, and health status information on type of MC programs implemented. Findings show that the effects of MC are concentrated on CWCHC and that CWCHC experience reductions in use of specialist, mental health, and prescription drugs. Capitated programs with mental health or specialty carve-outs are associated with a greater number and larger decreases in service use compared to integrated capitated programs. While it is not possible to determine whether MC programs resulted in more appropriate use of services, corresponding reductions in perceived access were not observed, suggesting that net effects of MC on service use represent improvements in care coordination.

引用

页码：356 / 372

页数：17

共 26 条

[1] Medicaid managed care and health care for children [J].