Minority Youth in Foster Care

Managed Care and Access to Mental Health Treatment

Datos Bibliográficos

ID9103564
AutoresL R Snowden (0000-0003-1722-699X, University of California, Berkeley, autor de correspondencia), Amelia E Cuéllar (0000-0001-6702-7601, Columbia University), Alison Evans Cuellar, Anne M Libby (0000-0002-4564-9407, University of Colorado Health)
Año2003
Volumen41
Número2
Páginas264-274
Fecha de publicación2003-02-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/01.mlr.0000044906.77195.8a
PMID12555054
OpenAlexW1969084415
IdiomaEN
Citas recibidas11
Referencias citadas17

BACKGROUND: Public sector mental health treatment has been transformed in recent years by the advent of managed care, but investigators of managed care policy have not yet focused on ethnic minority children, especially those involved with the child welfare system. Because of an overrepresentation of high-need minority children, foster care in particular is important to consider. OBJECTIVES: The present study examined children placed in foster care and documented differences between minority children and youth (black persons, Hispanic persons, and white persons) in use of mental health services. The primary concern of the study was to consider whether there were differences in access to services or service use among the groups in the transition to capitated managed care. MATERIALS AND METHODS: Medicaid claims and encounter data for two experimental managed care sites and one comparison fee-for-service site are used in a "difference-in-difference" analysis to estimate a changes in inpatient, outpatient, and residential treatment center (RTC) utilization, controlling for patient characteristics. RESULTS: The study finds persistent declines in inpatient and outpatient use for all ethnic groups, persistent under-representation of Hispanic persons and black persons in treatment regardless of managed care, and greater use of RTCs by black persons and Hispanic persons that is attributable in part to managed care. CONCLUSIONS: Black and Hispanic children received more rather than less mental health care under capitated managed care. The significance of this shift, largely increased in use of RTCs, however, cannot be determined at present, as the effectiveness of treatment delivered in RTCs is not known

Ambulatory care · Ethnic group · Family medicine · Foster care · Health care · Managed care · Medicaid · Medicaid managed care · Mental health · Psychiatry · Child Abuse and Trauma · Child and Adolescent Psychosocial and Emotional Development · Child Welfare and Adoption · Medicine · Nursing · Gerontology