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THE IMPACT OF MEDICAID EXPANSION INITIATIVES AND COUNTY CHARACTERISTICS ON THE HEALTH AND HEALTHCARE ACCESS OF OHIO’S CHILDREN

Diggs, Jessica Carmelita
http://rave.ohiolink.edu/etdc/view?acc_num=case1144677107

Abstract Details

2006, Doctor of Philosophy, Case Western Reserve University, Epidemiology and Biostatistics.
Since the initiation of the State Children’s Health Insurance Program, Ohio has been at the forefront of providing insurance coverage to children, through simplifying enrollment, expanding eligibility for children up to 200% of the Federal Poverty Level (FPL), and through Medicaid outreach. To counteract the enrollment losses attributed to welfare reform, $16.9 million was appropriated to Ohio to use for Medicaid outreach. Activities ranged from education and promotional campaigns to the development of community and interagency collaborations. The evaluation of these expansion activities is imperative to ensuring that resources are properly allocated, that effective expansion activities continue, and that the most vulnerable children are reached. The aims of this dissertation research were therefore to 1) to determine how access to healthcare and health status changed over the expansion period 1998-2004; 2) to identify individual- and county-level factors associated with these changes; and 3) to characterize children who were not reached by these expansions. Key indicators of access and health status assessed included insurance status, usual source of healthcare, healthcare needs, and health status. The results of this research indicate that there were significant and dramatic improvements in access to care. The proportion of Medicaid recipients tripled with the largest increase among children with household incomes between 100% and 200% of the poverty level. The likelihood of children having health insurance, a usual source of care, and their healthcare needs met also increased. Educating families of eligible children and the availability of primary care physicians are important to ensuring favorable enrollment outcomes at the county level. While the majority of children in Ohio have adequate access to care, several groups with multiple risk factors such as older age, lower household income, and minorities remained with reduced access. More importantly, coverage expansions were not shown to be associated with better reported health status at the end of the study period, despite significant improvements in access measures. Future research should focus on determining the factors responsible for this paradox and suggesting policies to ensure that access to healthcare actually translates into improved health status and that the needs of Ohio’s children are identified and addressed.
Siran Koroukian (Advisor)
206 p.
Health Sciences, Public Health
children's health insurance; Medicaid; SCHIP; Ohio; healthcare access

Recommended Citations

Citations

  • Diggs, J. C. (2006). THE IMPACT OF MEDICAID EXPANSION INITIATIVES AND COUNTY CHARACTERISTICS ON THE HEALTH AND HEALTHCARE ACCESS OF OHIO’S CHILDREN [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1144677107

    APA Style (7th edition)

  • Diggs, Jessica. THE IMPACT OF MEDICAID EXPANSION INITIATIVES AND COUNTY CHARACTERISTICS ON THE HEALTH AND HEALTHCARE ACCESS OF OHIO’S CHILDREN. 2006. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1144677107.

    MLA Style (8th edition)

  • Diggs, Jessica. "THE IMPACT OF MEDICAID EXPANSION INITIATIVES AND COUNTY CHARACTERISTICS ON THE HEALTH AND HEALTHCARE ACCESS OF OHIO’S CHILDREN." Doctoral dissertation, Case Western Reserve University, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=case1144677107

    Chicago Manual of Style (17th edition)

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© 2006, all rights reserved.
This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.