The impact of managed care on children's access, satisfaction, use, and quality of care.
OBJECTIVE
To examine the impact of managed care on children's access, satisfaction, use, and quality of care using nationally representative household survey data.


METHODS
The 1996 Medical Expenditure Panel Survey (MEPS).


METHODS
Bivariate and multivariate analyses are used to detect independent effects of managed care on access, satisfaction, utilization, and quality of pediatric health services.


METHODS
Data were obtained from rounds 1, 2, and 3 of the 1996 MEPS. MEPS collects data on health care use, insurance, access, and satisfaction, along with basic demographic and health status information for a representative sample of the U. S. civilian, noninstitutionalized population. Our sample consists of 5,995 children between the ages of 0 and 17.


RESULTS
Among the 18 outcome indicators examined, the bivariate analysis revealed only three statistically significant differences between children enrolled in managed care and children in traditional health plans: children enrolled in managed care were more likely to receive physician services, more likely to have access to office-based care during evening or weekend hours, and less likely to report being very satisfied with overall quality of care. However, after controlling for confounding factors, none of these differences remained statistically significant.


CONCLUSIONS
Our findings suggest that there are no statistically significant differences in self-reported outcomes for children enrolled in managed care and traditional health plans. This conclusion is provisional, however, because of limitations in the data set.
Newacheck
P W
PW
Institute for Health Policy Studies, San Francisco, CA 94118, USA.
Hung
Y Y
YY
Marchi
K S
KS
Hughes
D C
DC
Pitter
C
C
Stoddard
J J
JJ
D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D002662:Child Health Services / Q000592:standards* / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015986:Confounding Factors, Epidemiologic; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health / Q000145:classification / Q000706:statistics & numerical data; D008297:Male; D008329:Managed Care Programs / Q000458:organization & administration*; D009819:Office Visits; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States