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Financial Burden of Raising CSHCN: Association With State Policy Choices.
- Source :
-
Pediatrics . Dec2009 Supplement 4, Vol. 124, pS435-S442. 8p. - Publication Year :
- 2009
-
Abstract
- OBJECTIVE: We examined the association between state Medicaid and State Children's Health Insurance Program (SCHIP) income eligibility and the financial burden reported by low-income families raising children with special health care needs (CSHCN). SAMPLE AND METHODS: Data on low-income CSHCN and their families were from the National Survey of Children With Special Health Care Needs (N = 17039), with a representative sample from each state. State Medicaid and SCHIP income-eligibility thresholds were from publicly available sources. The 3 outcomes included whether families had any out-of-pocket health care expenditures during the previous 12 months for their CSHCN, amount of expenditure, and expenditures as a percentage of family income. We used multilevel logistic regression to model the association between Medicaid and SCHIP characteristics and families' financial burden, controlling state median income and child- and family-level characteristics. RESULTS: Overall, 61% of low-income families reported expenditures of >$0. Among these families, 30% had expenses between $250 and $500, and 34% had expenses of more than $500. Twenty-seven percent of the families reporting any expenses had expenditures that exceeded 3% of their total household income. The percentage of low-income families with out-of-pocket expenses that exceeded 3% of their income varied considerably according to state and ranged from 5.6% to 25.8%. Families living in states with higher Medicaid and SCHIP income-eligibility guidelines were less likely to have high absolute burden and high relative burden. CONCLUSIONS: Beyond child and family characteristics, there is considerable state-level variability in low-income families' out-of-pocket expenditures for their CSHCN. A portion of this variability is associated with states' Medicaid and SCHIP income-eligibility thresholds. Families living in states with more generous programs report less absolute and relative financial burden than families living in states with less generous benefits. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00314005
- Volume :
- 124
- Database :
- Academic Search Index
- Journal :
- Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 47153788
- Full Text :
- https://doi.org/10.1542/peds.2009-1255P