Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system

被引：27
作者：
Raghavan, Ramesh
Leibowitz, Arleen A.
Andersen, Ronald M.
Zima, Bonnie T.
Schuster, Mark A.
Landsverk, John
机构：
[1] Washington Univ, George Warren Brown Sch Social Work, St Louis, MO 63130 USA
[2] Univ Calif Los Angeles, Dept Publ Policy, Los Angeles, CA USA
[3] Univ Calif Los Angeles, Dept Hlth Serv, Los Angeles, CA USA
[4] Univ Calif Los Angeles, Dept Sociol, Los Angeles, CA USA
[5] Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA
[6] Univ Calif Los Angeles, Dept Pediat, Los Angeles, CA USA
[7] Univ Calif Los Angeles, Dept Hlth Serv, Los Angeles, CA USA
[8] RAND Corp, Santa Monica, CA USA
[9] Child & Adolescent Serv & Res Ctr, San Diego, CA USA
来源：
CHILDREN AND YOUTH SERVICES REVIEW | 2006年 / 28卷 / 12期
基金：
美国医疗保健研究与质量局;
关键词：
carve-out; Medicaid; child welfare; mental health; children;
D O I：
10.1016/j.childyouth.2006.04.001
中图分类号：
D669 [社会生活与社会问题]; C913 [社会生活与社会问题];
学科分类号：
1204 ;
摘要：
Children in the child welfare system are dependent upon Medicaid to finance services for their considerable mental health needs. This study examines the effects of Medicaid policies on mental health service use among a national probability sample of children in the child welfare system. Data for this study came from the National Survey of Child and Adolescent Well-Being, the Caring for Children in Child Welfare study, and the Area Resource File. Weighted multivariate logistic regression analyses were conducted to estimate effects of policy variables on children's use of mental health services, controlling for child-level covariates and county-level health resources. Children in counties with behavioral carve-outs under Medicaid managed care had lower odds of inpatient mental health service use. Medicaid managed care enrollment and variations in type of provider reimbursement did not affect use of mental health services. Older age, greater need for mental health services, and higher levels of caregiver education were associated with increased odds of service use. Restrictions on use of inpatient mental healthcare caused by behavioral carve-outs may disproportionately affect children in the child welfare system who have high rates of such use. Careful adoption of carve-outs is necessary to assure appropriate care for these children. (c) 2006 Published by Elsevier Ltd.
引用
收藏
页码：1482 / 1496
页数：15
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