title: Parent caregiver-related predictors of health care service utilization by children with cerebral palsy enrolled in Medicaid.
abstract: BACKGROUND
  This study examined the associations between characteristics of the parent caregiver and health care service utilization by children with cerebral palsy enrolled in Medicaid.
  
  
  METHODS
  A questionnaire was administered to the parents of children with cerebral palsy being treated in a North Carolina hospital, and the responses were linked with health services claims data from Medicaid. Data were available for 93 patients who maintained 1 year of continuous enrollment. The impact of selected demographic variables (race, years the child had the condition, employment, transportation) and behavioral variables (belief the child was receiving appropriate care, willingness to use home nursing and respite services, self-assessment of the severity of the child's condition, and use of orthopedic aids) on the frequency and costs of health care services was explored with use of multiple regression analysis.
  
  
  RESULTS
  Parents who were willing to use home nursing and respite services were more likely to utilize these services, as well as inpatient facilities and orthopedic care, for their children (P <.05). However, parents who perceived that their child was receiving adequate care were less likely to utilize orthopedic care and home nursing for their children (P <.05).
  
  
  CONCLUSIONS
  The belief of the parents in the adequacy of care received by their child, as well as their willingness to utilize supplemental health care services, were major predictors of health care service utilization by children with cerebral palsy enrolled in Medicaid. Parents who believed that their children receive enough care may need to be targeted for care management and disease management programs to ensure the continuum of treatment and care for these children.
authors.affiliation: Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Balkrishnan
authors.forename: Michelle
authors.initials: M
authors.lastname: Naughton
authors.forename: Beth P
authors.initials: BP
authors.lastname: Smith
authors.forename: Janeen
authors.initials: J
authors.lastname: Manuel
authors.forename: L Andrew
authors.initials: LA
authors.lastname: Koman
mesh_terms: D000293:Adolescent; D017028:Caregivers; D002547:Cerebral Palsy / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D018588:Fee-for-Service Plans / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008484:Medicaid / Q000706:statistics & numerical data*; D009657:North Carolina; D014481:United States