• J A Gordon and T A Dupuie.
• Department of Emergency Medicine, Massachusetts General Hospital, Institute for Health Policy, Partners HealthCare System, Division of Emergency Medicine, Harvard Medical School, Boston, MA 02114-2696, USA. jgordon3@partners.org
• Acad Emerg Med. 2001 Nov 1; 8 (11): 1088-90.

UnlabelledIn 1997 the U.S. government funded the Children's Health Insurance Program (CHIP), but the 48 billion dollars initiative has had limited success in finding and enrolling uninsured children. While such children are more likely to receive care in emergency departments (EDs), no national initiative has targeted EDs for child health insurance outreach.ObjectiveAs a pilot study for a national multicenter study, this study evaluated the effectiveness of child health insurance outreach in an ED setting.MethodsThis was a prospective observational study of the outreach efforts of a single case manager from August 1998 to July 1999, performed at Foote Hospital ED in Jackson, Michigan (45,000 visits/year). All patients ResultsSeventy-eight children participated (median age 7 years; 55% male; 87% white). Forty-four percent (95% CI = 32% to 55%) of families referred for government-sponsored child health insurance successfully obtained it; 31% (95% CI = 21% to 42%) could be traced directly to intervention efforts by interview (n = 17) or by state records (n = 7). Nineteen percent (95% CI = 11% to 30%) got other private insurance. Of those who got government-sponsored insurance due to the intervention, all but one were covered by Medicaid.ConclusionsThe ED may be an important outreach site for child health insurance programs. National efforts to address the lack of insurance among children should include partnerships with the ED.

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