title: Children with Special Health Care Needs in CHIP: Access, Use, and Child and Family Outcomes.
abstract: OBJECTIVE
  To assess how the Children's Health Insurance Program (CHIP) affects outcomes for children with special health care needs (CSHCN).
  
  
  METHODS
  We used data from a survey of parents of recent and established CHIP enrollees conducted from January 2012 through March 2013 as part of a congressionally mandated evaluation of CHIP. We identified CSHCN in the sample using the Child and Adolescent Health Measurement Initiative's CSHCN screener. We compared the health care experiences of established CHIP enrollees to the pre-enrollment experiences of previously uninsured and privately insured recent CHIP enrollees, controlling for observable characteristics.
  
  
  RESULTS
  Parents of 4142 recent enrollees and 5518 established enrollees responded to the survey (response rates, 46% recent enrollees and 51% established enrollees). In the 10 survey states, about one-fourth of CHIP enrollees had a special health care need. Compared to being uninsured, parents of CSHCN who were established CHIP enrollees reported greater access to and use of medical and dental care, less difficulty meeting their child's health care needs, fewer unmet needs, and better dental health status for their child. Compared to having private insurance, parents of CSHCN who were established CHIP enrollees reported similar levels of access to and use of medical and dental care and unmet needs, and less difficulty meeting their child's health care needs.
  
  
  CONCLUSIONS
  CHIP has significant benefits for eligible CSHCN and their families compared to being uninsured and appears to have some benefits compared to private insurance.
authors.affiliation: Mathematica Policy Research, Ann Arbor, Mich. Electronic address: jzickafoose@mathematica-mpr.com.
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Zickafoose
authors.affiliation: Mathematica Policy Research, Ann Arbor, Mich.
authors.forename: Kimberly V
authors.initials: KV
authors.lastname: Smith
authors.affiliation: Mathematica Policy Research, Princeton, NJ.
authors.forename: Claire
authors.initials: C
authors.lastname: Dye
mesh_terms: D000293:Adolescent; D001249:Asthma; D001289:Attention Deficit Disorder with Hyperactivity; D002648:Child; D002653:Child Behavior Disorders; D002662:Child Health Services; D002675:Child, Preschool; D065326:Children's Health Insurance Program; D019955:Conduct Disorder; D003752:Dental Health Services; D005190:Family; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019458:Insurance Coverage; D008297:Male; D017057:Medically Uninsured; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D014481:United States
keywords: Children's Health Insurance Program; children with special health care needs; health care access; health care utilization; public health insurance