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Continuity of Care for Children in Foster Care
- Source :
- Pediatrics. 111:e208-e213
- Publication Year :
- 2003
- Publisher :
- American Academy of Pediatrics (AAP), 2003.
-
Abstract
- Objective. To compare the continuity of care experienced by children who are in foster care with that of children who are not in foster care and are covered under Medicaid managed care and Medicaid fee-for-service (FFS).Methods. This retrospective cohort study used Medicaid claims/encounter data from Washington state. A total of 903 children who were in foster care and continuously enrolled in Medicaid for 24 months (1998–1999) were matched by age, gender, and rural/urban residence to 903 Medicaid managed care enrollees and 903 FFS beneficiaries who were not in foster care. Indices of the continuity of primary care experienced were calculated for each patient, and differences in continuity among the cohorts were assessed by running 3 multiple linear regression models for all possible pairings of cohorts, controlling for age, gender, rural/urban residence, and total number of primary care visits.Results. Foster care status was associated with decreased continuity of care relative to nonfoster managed care status (β = −0.12; 95% confidence interval [CI]: −0.15 to −0.09). Nonfoster FFS status was associated with lower continuity than managed care (β = −0.09; 95% CI: −0.12 to −0.06) and slightly higher continuity than foster care status (β = 0.03; 95% CI: 0.01–0.06).Conclusion. Although not dramatically different, continuity seems somewhat lacking for children in foster care. It is unclear to what degree the observed difference is confounded by the managed care/FFS distinction. As the enrollment of children in foster care into managed care plans has been controversial, efforts to promote the consistency of contact with providers while maintaining the flexibility afforded by FFS coverage seem warranted.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Child Health Services
Foster Home Care
Cohort Studies
Humans
Medicine
Child
health care economics and organizations
Retrospective Studies
Primary Health Care
Medicaid managed care
Medicaid
business.industry
Managed Care Programs
Fee-for-Service Plans
Retrospective cohort study
Continuity of Patient Care
Foster care
Child, Preschool
Family medicine
Pediatrics, Perinatology and Child Health
Regression Analysis
Managed care
Female
Residence
business
Cohort study
Subjects
Details
- ISSN :
- 10984275 and 00314005
- Volume :
- 111
- Database :
- OpenAIRE
- Journal :
- Pediatrics
- Accession number :
- edsair.doi.dedup.....daa7161e93eaeec840cee58da743bfd5
- Full Text :
- https://doi.org/10.1542/peds.111.3.e208