Insuring Uninsured Children

为没有保险的儿童提供保险

• 批准号: 6795566
• 负责人: GLENN FLORES
• 金额: $ 9.98万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-18 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6795566
• 关键词: Hispanic Americans; child (0-11); clinical research; focus groups; health insurance; health science research analysis /evaluation; health services research tag; human subject; pediatrics

The long-term career goal of the candidate, Glenn Flores, MD, is to become a recognized leader in child health services research through outstanding contributions as an investigator, clinician, mentor, and advocate. He has endeavored to conduct research that has the potential to have an immediate impact on children's health, particularly those who are minority, poor, and under- served by the health care system. Dr. Flores considers his publications, research funding, track record as a mentor, and national recognition as a speaker and consultant to be strong evidence of his success as an investigator and potential to make future contributions to the field. The candidate's career development plan includes: 1) refining research skills in conducting focus groups and randomized trials; 2) regular meetings with a senior advisory team; 3) completing a course on the responsible conduct of research; 4) mentoring minority health services researchers; and 5) developing and using collaborative policy links. The institutional environment provides excellent resources, including departmental commitment to protect 80 percent of Dr. Flores's effort for the proposed research, a senior advisory team of renown pediatric health services researchers, and needed support staff and equipment. The aims of the proposed research are to 1) use focus groups to identify the reasons why parents are unable to obtain health insurance for their uninsured children, with an emphasis on Latinos; and 2) conduct a randomized trial to evaluate whether case managers are more effective than traditional methods in insuring uninsured children. Eleven million children are uninsured in the US, and the number grows yearly, despite the Children's Health Insurance Programs (CHIP). States are having difficulty identifying and enrolling uninsured children, and unused CHIP fiends are in danger of being lost. We will conduct 6 focus groups on obstacles to insuring children in the communities identified by pilot work to have particularly high proportions of uninsured children. Focus group data will be used to train case managers to assist families with insurance eligibility, applications, and maintaining coverage. Uninsured children (N = 300) will be recruited and randomized to trained case managers, or a control group with access only to traditional methods of insurance enrollment. Outcomes examined will include: the proportion of children obtaining health insurance coverage, the time from study enrollment to obtaining coverage, the proportion of children with episodic coverage, and parental satisfaction with the process of obtaining coverage. Subjects in both groups will receive participation incentives and be contacted monthly to monitor outcomes for 1-2 years (depending on time of enrollment); intervention subjects also will be contacted monthly for ongoing assistance by case managers. Pilot work has identified several communities with high proportions of uninsured children that are willing to participate in research. The proposed project is timely because it rigorously evaluates the effectiveness of a specific, reproducible approach in a high-risk population. If successful, the intervention could serve as a national model for insuring uninsured children.

候选人Glenn Flores，医学博士的长期职业目标是通过作为研究人员，临床医生，导师和倡导者的出色贡献来成为儿童健康服务研究的公认领导者。 他努力进行研究，可能会对儿童的健康产生直接影响，尤其是那些由少数群体，贫困和医疗保健系统服务的人。 弗洛雷斯（Flores）博士认为他的出版物，研究资金，作为导师的往绩记录以及作为议长和顾问的国家认可，是他作为研究人员成功的有力证据，并有可能为该领域做出未来的贡献。候选人的职业发展计划包括：1）提高进行焦点小组和随机试验的研究技能； 2）与高级顾问团队定期会议； 3）完成有关负责研究的课程； 4）指导少数民族卫生服务研究人员； 5）制定和使用协作策略链接。 机构环境提供了出色的资源，包括部门的承诺，以保护弗洛雷斯博士为拟议研究的80％的努力，著名儿科健康服务研究人员的高级顾问团队，以及需要支持人员和设备。拟议研究的目的是对1）使用焦点小组来确定父母无法为其未投保的孩子获得健康保险的原因，并着重于拉丁美洲人； 2）进行一项随机试验，以评估案件经理是否比传统方法更有效，以确保没有保险的儿童。 尽管儿童健康保险计划（CHIP），但在美国没有保险的一千万儿童，每年都有数字增加。 各州在识别和注册未保险的孩子方面遇到困难，未使用的碎屑魔鬼有可能丢失的危险。 我们将在飞行员工作确定的社区中为儿童提供特别高比例的未保险儿童的社区中的儿童的6个焦点小组。 焦点小组数据将用于培训案例经理，以帮助拥有保险资格，申请和维护承保范围的家庭。 未投保的儿童（n = 300）将被招募并随机分配给训练有素的案件经理，或者仅访问传统保险招生方法的对照组。 所检查的结果将包括：获得健康保险覆盖率的儿童比例，从学习入学到获得覆盖范围的时间，具有情节性覆盖范围的儿童比例以及父母对获得承保范围的过程的满意度。 两组中的受试者将获得参与激励措施，并每月与每月联系以监控结果1 - 2年（取决于入学时间）；还将每月与干预对象联系，以供案件经理进行持续的帮助。 飞行员工作已经确定了几个愿意参与研究的未保险儿童比例很高的社区。 拟议的项目之所以及时，是因为它严格评估了高风险人群中特定的可重复方法的有效性。 如果成功的话，干预措施可以作为确保未保险儿童的国家模式。