Language proficiency and the enrollment of Medicaid-eligible children in publicly funded health insurance programs.

被引:43
作者
Feinberg E. [1 ]
Swartz K. [1 ]
Zaslavsky A.M. [1 ]
Gardner J. [1 ]
Walker D.K. [1 ]
机构
[1] Harvard School of Public Health, Boston, Massachusetts
关键词
access to care; Medicaid; SCHIP; health insurance; children; limited English proficiency (LEP);
D O I
10.1023/A:1014308031534
中图分类号
学科分类号
摘要
OBJECTIVES: The purpose of the study was to examine the effect of language proficiency on enrollment in a state-sponsored child health insurance program. METHODS: 1055 parents of Medicaid-eligible children, who were enrolled in a state-sponsored child health insurance program, were surveyed about how they learned about the state program, how they enrolled their children in the program, and perceived barriers to Medicaid enrollment. We performed weighted chi2 tests to identify statistically significant differences in outcomes based on language. We conducted multivariate analyses to evaluate the independent effect of language controlling for demographic characteristics. RESULTS: Almost a third of families did not speak English in the home. These families, referred to as limited English proficiency families, were significantly more likely than English-proficient families to learn of the program from medical providers, to receive assistance with enrollment, and to receive this assistance from staff at medical sites as compared to the toll-free telephone information line. They were also more likely to identify barriers to Medicaid enrollment related to "know-how"--that is, knowing about the Medicaid program, if their child was eligible, and how to enroll. Differences based on language proficiency persisted after controlling for marital status, family composition, place of residence, length of enrollment, and employment status for almost all study outcomes. CONCLUSIONS: This study demonstrates the significant impact of English language proficiency on enrollment of Medicaid-eligible children in publicly funded health insurance programs. Strong state-level leadership is needed to develop an approach to outreach and enrollment that specifically addresses the needs of those with less English proficiency.
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页码:5 / 18
页数:13
相关论文
共 49 条
[1]  
Selden TM(1998)Medicaid's problem children: Eligible but not enrolled Health Affairs 17 192-200
[2]  
Banthin JS(1998)The demographic characteristics of Medicaid-eligible uninsured children Am J Public Health 88 445-7
[3]  
Cohen JC.(1999)Waiting in the wings: Eligibility and enrollment in the State Children's Health Insurance Program Health Affairs 18 126-33
[4]  
Avruch S(1998)Children's health insurance, access to care, and health status: New findings Health Affairs 17 127-36
[5]  
Machlin S(2000)Racial/ethnic differences in children's access to care Am J Public Health 90 1771-4
[6]  
Bonin P(1991)Language of interview: Relevance for research of southwest Hispanics AmJ Public Health 81 1339-1404
[7]  
Ullman F.(1999)Language barriers and resource utilization in a pediatric emergency department Pediatrics 103 1253-6
[8]  
Selden TM(1994)The termination of a randomized clinical trial for poor Hispanic children Arch Pediatr Adolesc Med 148 364-7
[9]  
Banthin JS(1999)Enrollment in the State Child Health Insurance Program:Aconceptual framework for evaluation and continuous quality improvement Milbank Q 77 181-204
[10]  
Cohen JW.(1996)Will uninsured people volunteer for voluntary health insurance? Experience from Washington State Am J Public Health 86 529-32