Shirley L Porterfield1, LeaAnne DeRigne. 1. School of Social Work, University of Missouri-St Louis, St Louis, MO 63121, USA. porterfields@umsl.edu
Abstract
OBJECTIVE: We examined key factors that affect out-of-pocket medical expenditures per $1000 of household income for children with special health care needs (CSHCN) with a broad range of conditions, controlling for insurance type and concentrating on the potentially moderating role of the medical home. METHODS: A Heckman selection model was used to estimate whether the medical home influenced out-of-pocket medical costs per $1000 of household income for children covered by either private or public health insurance. Data from the 2005-2006 National Survey of CSHCN (N = 31,808) were used. RESULTS: For families that incurred out-of-pocket medical costs for their CSHCN, these costs represented 2.2% to 3.9% of income. Both insurance type and the medical home had significant effects on out-of-pocket costs. Lower out-of-pocket medical costs per $1000 of income were incurred by children with public insurance and those receiving care coordination services. CONCLUSIONS: Families with CSHCN incur lower out-of-pocket medical costs when their children receive health care in a setting in which the care-coordination component of the medical home is in place.
OBJECTIVE: We examined key factors that affect out-of-pocket medical expenditures per $1000 of household income for children with special health care needs (CSHCN) with a broad range of conditions, controlling for insurance type and concentrating on the potentially moderating role of the medical home. METHODS: A Heckman selection model was used to estimate whether the medical home influenced out-of-pocket medical costs per $1000 of household income for children covered by either private or public health insurance. Data from the 2005-2006 National Survey of CSHCN (N = 31,808) were used. RESULTS: For families that incurred out-of-pocket medical costs for their CSHCN, these costs represented 2.2% to 3.9% of income. Both insurance type and the medical home had significant effects on out-of-pocket costs. Lower out-of-pocket medical costs per $1000 of income were incurred by children with public insurance and those receiving care coordination services. CONCLUSIONS: Families with CSHCN incur lower out-of-pocket medical costs when their children receive health care in a setting in which the care-coordination component of the medical home is in place.
Authors: Jean L Raphael; W Carl Cooley; Amanda Vega; Marc A Kowalkowski; Xuan Tran; Janet Treadwell; Angelo P Giardino; Thomas P Giordano Journal: J Health Care Poor Underserved Date: 2015-05
Authors: Sarah K Luthy; Sunkyung Yu; Janet E Donohue; Emefah Loccoh; Caren S Goldberg; Jimmy C Lu Journal: Pediatr Cardiol Date: 2015-09-05 Impact factor: 1.655