Protecting low-income children's access to care: are physician visits associated with reduced patient dropout from Medicaid and the Children's Health Insurance Program?

摘要: Objective Dropout among patients who are enrolled in Medicaid and the Children's Health Insurance Program contributes to a lack of health care access millions Americans. The purpose this study was determine which, if any, types clinical contact with physicians associated reduced dropout children Program. Methods data from nationally representative Medical Expenditure Panel Survey, 1998-2002. sample is composed all (n = 3043) were reported have or coverage throughout their first year survey did not acquire other insurance during period. outcome measure whether an individual remained by end following year. Exposure variables individual's survey: numbers office visits, hospital outpatient department emergency inpatient stays, dental visits. analysis uses multivariate logistic regression control for patient family characteristics-most important, status, functional overall expenditures. Results Eight percent had left Medicaid/the second survey. More frequent clinicians setting significantly lower risk dropping out children, even controlling demographics, After adjustment, more departments also dropout, borderline statistically significant odds ratio. Notably, visits stays any change Medicaid/Children's dropout. Conclusions These results suggest that some but clinician serving important function maintaining low-income patients. Two possible approaches improve therefore would be (1) increased awareness clinicians, especially hospitals departments, regarding retention as issue ongoing (2) reimbursement staff assisting public renewal process.