The Safety Net, Medicaid, and Child Health Outcomes

安全网、医疗补助和儿童健康成果

• 批准号: 7559051
• 负责人: ANTHONY T LOSASSO
• 金额: $ 25.32万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-01 至 2011-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7559051
• 关键词: Address; Affect; Area; Attention; Bile fluid; Caring; Characteristics; Child; Child health care; Clinic; Communities; Crowding; Data; Data Set; Eligibility Determination; Ethnic Origin; Expenditure; Federally Qualified Health Center; Funding; Grant; Gray unit of radiation dose; Health; Health Insurance; Health Personnel; Healthcare; Hospitals; Immunization; Indigent Care; Information Systems; Institution; Insurance; Insurance Coverage; Measurement; Measures; Mechanics; Medicaid; Methods; National Health Interview Survey; National Hospital Discharge Survey; Outcome; Patients; Policies; Policy Maker; Provider; Public Hospitals; Race; Relative (related person); Research; Research Personnel; Rosa; State Children' s Health Insurance Program; Surveys; Taxes; Teaching Hospitals; Uncompensated Care; Underinsured; Uninsured; Vital Statistics; Work; base; instrument; meetings; payment; programs; safety net; simulation

DESCRIPTION (provided by applicant): The percentage of children without health insurance was 11.4% in 2003, which is down from 12.9% in 1987, but nonetheless stubbornly high despite the large expansions during this period in Medicaid coverage and the introduction of the State Children's Health Insurance Program (SCHIP): the percentage of children eligible for public insurance rose from 17.8% in 1987 to 41.7% in 2000. Most recently, $40 billion in federal matching funds were allocated over ten years beginning in 1998 to fund the SCHIP expansions. The uninsured are forced to depend heavily on "safety net" providers to meet their health care needs. The health care safety net in most communities is made up of a patchwork of health care providers that include public hospitals, teaching hospitals, community-based clinics, and local health departments among others. The importance of safety net providers has been highlighted by the Bush Administration's proposed five-year $780 million Initiative for Health Centers that would enable the health centers to reach an additional 6.1 million patients by the end of Fiscal Year 2006. While there are numerous studies examining how the uninsured and underinsured affect the health care safety net, comparatively little research has examined the converse: how the health care safety net affects the health of those who use it. Similarly, while a number of studies have attempted to relate Medicaid expansions to child health outcomes, few studies have attempted to relate characteristics and aspects of the health care safety net to children's health outcomes. This application proposes to use national data to examine how the provision of care through the health care safety net affects health outcomes for children. In addition, a related aim to be addressed in this study to determine where marginal dollars are most effectively spent in terms of their impact on child health: on increasing public insurance eligibility or on directly funding or subsidizing the provision of indigent care by the health care safety net. A final area of study will examine how the relationship between the health care safety net and children's health outcomes differs by race and ethnicity.

说明（申请人提供）： 2003 年，没有医疗保险的儿童比例为 11.4%，低于 1987 年的 12.9%，但尽管这一时期医疗补助覆盖范围大幅扩大，并引入了国家儿童健康保险计划 (SCHIP)，但仍然居高不下：有资格参加公共保险的儿童比例从 1987 年的 17.8% 上升到 2003 年的 41.7%。 2000 年。最近，联邦配套资金达 400 亿美元 从 1998 年开始的十年间，拨款用于资助 SCHIP 的扩建。没有保险的人被迫严重依赖“安全网”提供者来满足他们的医疗保健需求。大多数社区的医疗保健安全网由众多医疗保健提供者组成，其中包括公立医院、教学医院、社区诊所和当地卫生部门等。布什政府提出的为期五年、耗资 7.8 亿美元的健康中心计划凸显了安全网提供者的重要性，该计划将使健康中心到 2006 财政年度结束时能够为额外的 610 万名患者提供服务。尽管有大量研究探讨未参保和参保不足的人如何影响医疗保健安全网，但相对较少的研究却反其道而行之：医疗保健安全网如何影响其使用者的健康。同样，虽然许多研究试图将医疗补助的扩展与儿童健康结果联系起来，但很少有研究试图将医疗保健安全网的特征和方面与儿童健康结果联系起来。该申请建议使用国家数据来研究通过医疗保健安全网提供的医疗服务如何影响儿童的健康结果。此外，本研究要解决的一个相关目标是确定边际资金在对儿童健康的影响方面最有效地花在哪里：增加公共保险资格或直接资助或补贴医疗保健安全网提供的贫困护理。最后一个研究领域将研究医疗保健安全网与儿童健康结果之间的关系如何因种族和民族而异。