Medical care
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Comparative Study
Does public insurance provide better financial protection against rising health care costs for families of children with special health care needs?
Health care costs grew rapidly since 2001, generating substantial economic pressures on families, especially those with children with special health care needs (CSHCN). ⋯ Rising health care costs increased financial burden on families of CSHCN in 2001-2004. Public insurance coverage provided better financial protection than private insurance against the rapidly rising health care costs for families of CSHCN.
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The 1997 State Children's Health Insurance Program (SCHIP) program allowed states to expand Medicaid to uninsured children through age 18 in families under 200% of the federal poverty level. Prepregnancy insurance coverage of adolescents may help reduce unintended pregnancies, address other medical issues, and allow for early and adequate prenatal care for those carrying to term. ⋯ The temporary extension of SCHIP allows time to consider how to maintain the program's potentially positive effect on the reproductive health of adolescents.
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Teens and racial and ethnic minority women are less likely to initiate prenatal care (PNC) in the first trimester of pregnancy than their counterparts. ⋯ Providing public insurance coverage improves access to care but is not sufficient to meet Healthy People 2010 goals or eliminate racial and ethnic disparities in PNC initiation.
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Comparative Study
Minding the gap: a decomposition of emergency department use by Medicaid enrollees and the uninsured.
To examine differences in Emergency Department (ED) utilization between Medicaid enrollees and the uninsured. ⋯ Decomposition analysis results show that differences in measurable characteristics between the groups explain half of the disparity in visits. The remaining portion of the gap in ED utilization is driven by differences in unmeasured or unobserved characteristics between the groups such as care-seeking behavioral differences.