Document Detail

Differences in use of health services between White and African American children enrolled in Medicaid in North Carolina.
MedLine Citation:
PMID:  12710799     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Racial differences in health status and use of health services persist in the United States and are not completely explained by differences in socioeconomic status. This study examines differences in use of health services between White and African American children enrolled in Medicaid, controlling for other factors that affect service use. We make comparisons for use of primary preventive services, diagnosis and treatment of selected common childhood illnesses, and Medicaid expenditures. METHODS: We linked Medicaid enrollment records, Medicaid paid claims data, and data on use of child WIC services to birth certificates for North Carolina children born in 1992 to measure use of health services and Medicaid expenditures by race for children ages 1, 2, 3, and 4. Logistic and Tobit regression models were used to estimate the independent effect of race, controlling for other variables such as low birth weight, WIC participation, and mother's age, education, and marital status. Since all children enrolled in Medicaid are in families of relatively low income, racial differences in socioeconomic status are partially controlled. RESULTS: African American children had consistently lower Medicaid expenditures and lower use of health services than did White children, after statistically controlling for other maternal and infant characteristics that affect health service use, including child WIC participation. For example, total annual Medicaid expenditures were 207-303 dollars less for African American children than for White children, controlling for other variables. African America children were significantly less likely to receive well-child and dental services than were White children. CONCLUSIONS: African American children enrolled in Medicaid use health services much less than White children, even when controlling for socioeconomic status and other factors that affect service use. Linking state administrative databases can be a cost-effective way of addressing important issues such as racial disparities in health service use.
Paul A Buescher; Stephanie J Horton; Barbara L Devaney; Sarah J Roholt; Alice J Lenihan; J Timothy Whitmire; Jonathan B Kotch
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Maternal and child health journal     Volume:  7     ISSN:  1092-7875     ISO Abbreviation:  Matern Child Health J     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-04-24     Completed Date:  2003-06-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9715672     Medline TA:  Matern Child Health J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  45-52     Citation Subset:  IM    
State Center for Health Statistics, North Carolina Division of Public Health, Raleigh, North Carolina 27699-1908, USA.
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MeSH Terms
African Americans / statistics & numerical data*
Birth Certificates
Child Health Services / economics,  utilization*
European Continental Ancestry Group / statistics & numerical data*
Food Services / economics,  utilization
Health Expenditures / statistics & numerical data*
Medicaid / utilization*
North Carolina
Odds Ratio
Patient Acceptance of Health Care / ethnology
Preventive Health Services / economics,  utilization
Regression Analysis
Socioeconomic Factors
Utilization Review

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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