title: Impact of Medicaid/ SCHIP disenrollment on health care utilization and expenditures among children: a longitudinal analysis.
abstract: This study examines the impact of disenrolling from Medicaid/State Children's Health Insurance Programs (SCHIP) on health care utilization and expenditures among children using the 1996-2005 Medical Expenditure Panel Survey data. Changes in expenditures and utilization upon Medicaid/SCHIP disenrollment were examined for two disenrollment groups, children who became uninsured and those who transitioned to private insurance; relative to a control group, those continuously enrolled in Medicaid/SCHIP during the study period. In multivariate analysis, a modified two-part model and difference-in-difference analytic approach were used. The dependent variables were changes in total expenditures and changes in utilization (i.e., well-child visits, physician visits, emergency room visits, hospitalizations, and prescription drug use) from pre- to post-disenrollment round. This study found that losing Medicaid/SCHIP coverage is associated with decreased preventive care utilization among children, regardless of the insurance status post-disenrollment. In addition, children who become uninsured following Medicaid/SCHIP disenrollment may also experience reductions in physician visits and prescription drug use.
authors.affiliation: HealthCore, Inc., Wilmington, DE 19801, USA. jingboyu1@gmail.com
authors.forename: Jingbo
authors.initials: J
authors.lastname: Yu
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Harman
authors.forename: Allyson G
authors.initials: AG
authors.lastname: Hall
authors.forename: R Paul
authors.initials: RP
authors.lastname: Duncan
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data*; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D012044:Regression Analysis; D013221:State Health Plans; D014481:United States