The effects of access to pediatric care and insurance coverage on emergency department utilization.

@article{Johnson2004TheEO,
  title={The effects of access to pediatric care and insurance coverage on emergency department utilization.},
  author={William G. Johnson and Mary Ellen Rimsza},
  journal={Pediatrics},
  year={2004},
  volume={113 3 Pt 1},
  pages={
          483-7
        }
}
OBJECTIVE To compare children who used the emergency department (ED) in a rural, border community with those who did not over a 1-year period to estimate the effects of access to pediatric care, insurance coverage, ethnicity, gender, age, and area of residence on ED utilization. DESIGN Multivariate logit models are used to estimate the independent influence of demographic characteristics, insurance coverage, and access to pediatric care on ED utilization during 1999 by children 0 to 19 years… 
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The majority of the changes in use are attributable to changes in insurance status, which results in a shift of care from less expensive ambulatory settings to emergency departments and increases in hospital days when children lose Medicaid/State Children's Health Insurance Program coverage.
The impact of Medicaid on children's healthcare and health
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  • Medicine
    Current opinion in pediatrics
  • 2005
TLDR
The impact of the Medicaid program is reviewed, including the proportion of children in America insured by Medicaid; the extent to which Medicaid-enrolled children have access to care; the use of services and the quality of care received by Medicaid enrollees; and family satisfaction with the program.
The association between insurance status and emergency department disposition of injured California children.
TLDR
Privately insured, publicly insured, and uninsured injured children have disparate patterns of ED disposition, and policy and clinical efforts are needed to ensure that all injured children receive equitable emergency care.
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Although uninsured children had the lowest percentage of head injuries, there was no significant difference in body part injured by insurance type, and uninsured children were significantly more likely to be hospitalized after an injury than insured children.
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TLDR
Analysis from the first year of this pilot program demonstrates that by providing enhanced, coordinated, primary care access to Medicaid children, the utilization of the ED was significantly lowered among healthy children, whereas the overall cost of care remained the same.
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TLDR
Over the last decade, despite the presence of a usual source of care, a greater number of parents report visiting this urban PED during regular office hours for reasons unrelated to parental perceived urgency.
The Impacts of Health Insurance Coverage on Access to Healthcare in Children Entering Kindergarten
TLDR
Uninsured kindergartners were less likely to have had a check-up in the previous 12 months, and those children with public insurance were more likely to has unmet medical needs.
Evaluating the Impact of the Healthy Beginnings System of Care Model on Pediatric Emergency Department Utilization
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Enrollment in the SOC model does not appear to decrease the rate of emergency department visits among enrolled children, and additional strategies, such as education sessions on ED utilization, are needed to reduce the rates of ED utilization among SOC-enrolled children.
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