Cost of outpatient medical care for children and youth with special health care needs: investigating the impact of the medical home.
OBJECTIVE
Our goal was to evaluate the impact of having a medical home on the outpatient medical costs of children and youth with special health care needs.


METHODS
Data from 2 sources were matched at the individual level: (1) the 2002 Iowa Consumer Assessment of Health Plans Study survey of Medicaid enrollees and (2) Iowa Medicaid administrative claims, encounter, and enrollment files.


METHODS
The subjects were 1140 children aged 6 months to 12 years for whom both sources of data were available.


METHODS
Outcomes measures included medical homeness, as developed by a scale of items in the Consumer Assessment of Health Plans Study survey, and outpatient costs, as determined from Medicaid administrative data.


RESULTS
From the regression models, we found that (1) for all Medicaid-enrolled children, outpatient costs were significantly higher for female children and children and youth with special health care needs, (2) for children and youth without special health care needs, costs were significantly higher for female children, those with a personal doctor or nurse, and those with more of a medical home, and (3) for children and youth with special health care needs, costs were significantly higher for those in a lower health state, for those in health maintenance organization 2, and for older children.


CONCLUSIONS
Although the degree of medical homeness was not related to outpatient costs for children and youth with special health care needs, medical homeness may affect inpatient costs more than outpatient costs for children and youth with special health care needs and should be investigated further.
Damiano
Peter C
PC
Health Policy Research Program, University of Iowa, Public Policy Center, 227 S Quadrangle, Iowa City, IA 52242, USA. peter-damiano@uiowa.edu
Momany
Elizabeth T
ET
Tyler
Margaret C
MC
Penziner
Andrew J
AJ
Lobas
Jeffrey G
JG
D000367:Age Factors; D000553:Ambulatory Care / Q000191:economics; D002648:Child; D002662:Child Health Services / Q000191:economics* / Q000458:organization & administration; D002675:Child, Preschool; D003266:Continuity of Patient Care; D019988:Children with Disabilities; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006699:Home Care Services / Q000191:economics*; D006801:Humans; D007223:Infant; D008297:Male; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010045:Outpatients; D012044:Regression Analysis