Maternal and Child Health Journal

, Volume 16, Issue 4, pp 850–859

Unmet Need, Cost Burden, and Communication Problems in SCHIP by Special Health Care Needs Status

Authors

    • Institute for Health, Health Care Policy and Aging ResearchRutgers University
    • E.J. Bloustein School of Planning and Public PolicyRutgers University
  • Tamarie Macon
    • Institute for Health, Health Care Policy and Aging ResearchRutgers University
    • Combined Program in Education and PsychologyUniversity of Michigan
  • Dorothy Gaboda
    • Center for State Health PolicyRutgers University
  • Joel C. Cantor
    • Center for State Health PolicyRutgers University
    • E.J. Bloustein School of Planning and Public PolicyRutgers University
Article

DOI: 10.1007/s10995-011-0805-x

Cite this article as:
Miller, J.E., Macon, T., Gaboda, D. et al. Matern Child Health J (2012) 16: 850. doi:10.1007/s10995-011-0805-x

Abstract

Children with special health care needs (CSHCN) require more health care than other children; hence adequate health insurance is critical. The Maternal and Child Health Bureau defined three components of adequacy: (1) coverage of needed benefits and services; (2) reasonable costs; and (3) ability to see needed providers. This study compares cost burden, access to care, and patient/provider communication within New Jersey’s SCHIP for CSHCN versus those without such needs. We used data from the 2003 NJ FamilyCare (NJFC) Supplement to the New Jersey Family Health Survey on 444 children enrolled in NJFC and 145 children disenrolled from NJFC but covered by other insurance at the time of the survey. The CSHCN Screener was used to identify CSHCN. CSHCN in NJFC had 1.5 times the odds of an unmet need for health care; 2.7 times the odds of a cost burden; and 2.2 times the odds of any coverage or service inadequacy than those without SHCN, even when demographic factors and NJFC plan level (which is based on income) were taken into account. CSHCN enrolled in NJFC have more difficulties in some areas of access to care and cost burden. Patterns of access to care, cost burden, and patient/provider communication were similar for children formerly in NJFC who had other types of insurance at the time of the survey. Future studies should use comprehensive measures of adequacy of coverage, including attitudinal, structural and economic perspectives.

Keywords

Children with special health care needsChronic health conditionsHealth insuranceState Children’s Health Insurance ProgramUnderinsured

Copyright information

© Springer Science+Business Media, LLC 2011