Caregivers’ Ratings of Access
Do Children with Special Health Care Needs Fare Better Under Fee-for-Service or Partially Capitated Managed Care
Bibliographic Data
| ID | 9099192 |
|---|---|
| Authors | Jean M Mitchell (0000-0002-2765-4624, Public Policy Institute of California, corresponding author), Darrell J Gaskin (0000-0002-0822-1583, Johns Hopkins University) |
| Year | 2007 |
| Volume | 45 |
| Issue | 2 |
| Pages | 146-153 |
| Publication date | 2007-02-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/01.mlr.0000241047.99214.ed |
| PMID | 17224777 |
| OpenAlex | W2058308662 |
| Language | EN |
| Citations received | 4 |
| References cited | 15 |
OBJECTIVE: The objective of this study was to evaluate how enrollment in a partially capitated managed care (MC) option versus the fee-for-service (FFS) system affects caregivers' ratings of dimensions of access to services among children with special health care needs (SHCN). SUBJECTS: The data were collected from telephone interviews during the summer and fall of 2002 with a random sample of 1088 caregivers of children with SHCN who qualified for Supplemental Security Income and therefore were enrolled the Medicaid program for children with SHCN in the District of Columbia. RESEARCH DESIGN: We used a 2-step procedure in which we first estimated plan choice and then constructed a selectivity correction to control for the potential selection bias linked to plan choice. We estimated the second stage equations predicting caregiver's ratings of dimensions of access as a function of the selectivity correction, the plan choice dummy variable and other exogenous variables. RESULTS: After controlling for the potential selection bias linked to plan choice and other confounding factors, we find that caregivers of children in FFS are significantly more likely than caregivers of children enrolled in the partially capitated MC plan to rate the following dimensions of access as either fair or poor: "access to specialists' care" (P < 0.01), "access to emergency room care" (P < 0.01), "convenience of the doctor's office" (P < 0.01), and "waiting time between making the appointment actual visit" (P < 0.05). CONCLUSIONS: We attribute these differences in caregivers' ratings of dimensions of access that exist between partially capitated MC and FFS enrollees to case management and care coordination services along with higher fees paid for pediatrician's and specialists' services available under MC option
MEDLINE · Political science · Computer Science · Family and Disability Support Research · Geriatric Care and Nursing Homes · Healthcare Policy and Management · Medicine · Psychology
Problems with Instrumental Variables Estimation when the Correlation between the Instruments and the Endogenous Explanatory Variable is Weak
Sample Selection Bias as a Specification Error
Instrumental Variables Regression with Weak Instruments
Estimation and inference in econometrics
Plan Choice and Changes in Access to Care over Time for SSI-Eligible Children with Disabilities
Managed Care and Children
Improving State Medicaid Contracts and Plan Practices for Children with Special Needs
| Unique citing works | 4 |
|---|---|
| Citations per year | 0,22 |
| Citation span | 2008 - 2013 (6) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 4 |