The Role of Medicaid in Ensuring Children's Access to Care

作者：Paul W. Newacheck · 发表于：JAMA · 年份：1998 · DOI：10.1001/jama.280.20.1789 · 被引用次数：113 · 研究领域：Healthcare Policy and Management、Healthcare Systems and Reforms、Food Security and Health in Diverse Populations

CONTEXT: Congress enacted a series of laws beginning in the mid 1980s to expand Medicaid eligibility for children, especially those in poor families. As a result, Medicaid enrollment of children has nearly doubled over the past decade. OBJECTIVE: To assess the effectiveness of Medicaid in improving access to and use of health services by poor children. DESIGN: Analysis of cross-sectional survey data from the 1995 National Health Interview Survey. Poor children with Medicaid were compared to poor children without insurance and nonpoor children with private insurance. SETTING AND PARTICIPANTS: A total of 29711 children younger than 18 years (3716 poor children with Medicaid, 1329 poor children without insurance, 14609 nonpoor children with private insurance, and 10057 children with other combinations of poverty and insurance status) included in a nationally representative stratified probability sample of the US noninstitutionalized population. MAIN OUTCOME MEASURES: Usual source of care, access to a regular clinician, unmet health needs, and use of physician services. RESULTS: Poor children with Medicaid compared to poor children without health insurance experienced superior access across all measured dimensions of health care, including presence of a usual source of care (95.6% vs 73.8%), frequency of unmet health needs (2.1 % vs 5.9%), and use of medical services (eg, > or =1 physician contact in past year) (83.9% vs 60.7%). Poor children with Medicaid compared to nonpoor chi...