The first 2 years of a state child health insurance plan: whom are we reaching?
OBJECTIVE
The Colorado Child Health Plan Plus is a non-Medicaid state Child Health Insurance Plan. The objective of this study was to compare early enrolling (EE) children with uninsured children in low-income families (ULI) with respect to 1) sociodemographic factors and previous insurance, 2) health status, and 3) previous health care access and utilization.


METHODS
Cross-sectional telephone surveys were conducted during 1999 of 1) randomly selected EE children (n = 711) and 2) ULI children identified by random-dial survey (n = 105).


RESULTS
Enrolling children were less likely to be Hispanic (32.7% vs 55.2%); 5.5% of EE versus 27.6% of ULI children had never been insured. Prevalence of chronic conditions was similar (16.2% of EE vs 13.5% of ULI children), but learning/behavioral difficulties (9.7% of EE vs 18.6% of ULI) and fair/poor health (5.4% of EE vs 17.2% of ULI) were higher for uninsured children. In the previous year, 88.2% of EE versus 66.1% of ULI children had a usual source of care. The mean number of preventive visits was similar (1.4 vs 1.2), but the EE group reported a higher mean number of sick visits (2.0 vs 1.1), emergency visits (0.48 vs 0.15), and hospitalizations (0.09 vs 0.02).


CONCLUSIONS
In the first 2 years of the program, Child Health Plan Plus is not yet reaching the "hard-to-reach" but, rather, disproportionately high numbers of non-Hispanic children who already have a usual source of care and recent insurance. EE children did not have higher rates of chronic conditions but did demonstrate higher utilization before enrollment, possibly reflecting patterns of enrollment into the program.
Kempe
Allison
A
Department of Pediatrics and University of Colorado HSC, Denver, Colorado, USA. kempe.allison@tchden.org
Renfrew
Brenda
B
Barrow
Jennifer
J
Cherry
Darci
D
Levinson
Arnold
A
Steiner
John F
JF
D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data; D002675:Child, Preschool; D003120:Colorado; D003430:Cross-Sectional Studies; D004608:Eligibility Determination / Q000379:methods; D019538:Health Care Surveys / Q000379:methods; D006304:Health Status; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008489:Medical Indigency / Q000208:ethnology / Q000706:statistics & numerical data / Q000639:trends; D017057:Medically Uninsured / Q000208:ethnology / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013221:State Health Plans / Q000706:statistics & numerical data*; D014481:United States