ACCESS AND QUALITY OF CARE FOR LOW-INCOME ADOLESCENTS

低收入青少年获得护理的机会和质量

• 批准号: 6391121
• 负责人: Elizabeth A. Shenkman
• 金额: $ 19.66万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2003-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6391121
• 关键词: adolescence (12-20); clinical research; cooperative study; health behavior; health care cost /financing; health care policy; health care quality; health care service availability; health care service evaluation; health care service organization; health care service utilization; health insurance; health science research analysis /evaluation; health services research tag; health surveys; high risk behavior /lifestyle; human subject; interview; low socioeconomic status; managed care; pediatrics

The Title XXI initiative represents one of the largest state and federal efforts to provide insurance coverage for uninsured, law-income children and adolescents, the majority of whom will be placed in some type of managed care arrangement. Assessing health care quality in these programs for adolescents is critical because adolescents have unique health care needs; yet face many barriers to obtaining health care that is targeted toward those needs. While most adolescents are healthy, an increasing number are engaging in risk-taking behaviors that have potentially deleterious health effects, such as unprotected sexual activity and substance use. Others have chronic health conditions. The primary aim of the proposed research is to assess the effects of the organizational features of KidCare, Florida's children's health insurance program, on access to and provision of primary and preventive care for enrolled adolescents, ages 12 to 19. Adolescents with diagnoses that are indicative of risky behaviors and those with chronic conditions will be included. We will assess the organizational features of the KidCare Program components and the different MCOs and provider practices participating in MdCare on adolescents' primary and preventive care. The KidCare Program presents a unique opportunity to study 15 different MCOs and insurers, with diverse provider practices, and over 65,000 adolescents. In the proposed research, we will study the following organizational characteristics: 1. General organizational characteristics, 2. Marketing and educational strategies for outreach, 3. Financial arrangements with primary care providers, 4. Non-financial arrangements to control costs, 5. Quality assurance approaches, 6. Presence of adolescent wellness and care coordination programs, and 7. Use of technology systems. The following outcomes of care are included: compliance with preventive health care guidelines, health care use and expenditures, health status, missed school days, unmet need, satisfaction with care, and out-of-pocket spending for health care. The research design is quasi-experimental, with data collected prospectively over a two year period. To conduct this study, we will use rich data sets covering a range of adolescents who are enrolled in diverse managed care arrangements associated with Florida's Title XXI initiative. These data sets include person-level health care use and enrollment data supplemented with telephone survey data.

XXI倡议的标题是最大的州和联邦努力之一，为未投保的法律收入儿童和青少年提供保险范围，其中大多数将被置于某种类型的托管护理安排中。 为青少年评估这些计划中的医疗保健质量至关重要，因为青少年有独特的医疗保健需求；然而，面对获得针对这些需求的医疗保健的许多障碍。 尽管大多数青少年都很健康，但越来越多的人正在从事具有潜在有害健康影响的冒险行为，例如无保护的性活动和使用物质。 其他人有慢性健康状况。 拟议研究的主要目的是评估佛罗里达州儿童健康保险计划Kidcare的组织特征的影响，对12至19岁的注册青少年的初级和预防保健，年龄在12至19岁中。 我们将评估儿童护理计划组件的组织特征以及参与青少年的主要和预防保健的不同MCO和提供商实践。 Kidcare计划为研究15个不同的MCO和保险公司提供了独特的机会，具有不同的提供商实践，以及超过65,000名青少年。 在拟议的研究中，我们将研究以下组织特征：1。一般组织特征，2。外展的营销和教育策略，3。与初级保健提供者的财务安排，4。非财务安排以控制成本，5。质量保证方法，6。青少年健康和护理协调计划的存在，以及7。使用技术系统。 包括以下护理结果包括：遵守预防性医疗保健指南，医疗保健使用和支出，健康状况，错过的上学日子，未满足的需求，对护理的满意度以及医疗保健的自付费用。 研究设计是准实验性的，数据在两年内预期收集。 为了进行这项研究，我们将使用丰富的数据集，这些数据集涵盖了一系列与佛罗里达州标题XXI倡议相关的不同托管护理安排的青少年。 这些数据集包括补充电话调查数据的人级医疗保健使用和注册数据。

项目成果

Prior health care experiences of adolescents who enroll in SCHIP.

参加 SCHIP 的青少年之前的医疗保健经历。

• DOI: 10.1353/hpu.2006.0127
• 发表时间: 2006
• 期刊: Journal of health care for the poor and underserved
• 影响因子: 1.4
• 作者: Klein,JonathanD;Shenkman,Elizabeth;Brach,Cindy;Shone,LauraP;Col,Jana;Schaffer,VirginiaA;Dick,AndrewW;VanLandeghem,Karen;Szilagyi,PeterG
• 通讯作者: Szilagyi,PeterG

Congruence between parents' and adolescents' reports of special health care needs in a Title XXI program.

家长和青少年对第 XXI 章计划中特殊医疗保健需求的报告之间的一致性。

• DOI: 10.1093/jpepsy/jsg029
• 发表时间: 2003
• 期刊: Journal of pediatric psychology
• 影响因子: 3.6
• 作者: Youngblade,LiseM;Shenkman,ElizabethA
• 通讯作者: Shenkman,ElizabethA