Financial Burden of Raising CSHCN: Association With State Policy Choices

Susan L. Parish · Paul T. Shattuck · Roderick A. Rose

67 citations0/0 files storedPEDIATRICS

No readable copy stored yet — this record is metadata only.

No open-access location is known for this record yet.

Literature note Cite in a project Citation map

Healthcare Policy and Management Healthcare Systems and Reforms Economic and Financial Impacts of Cancer

Abstract

OBJECTIVE: We examined the association between state Medicaid and State Children's Health Insurance Program (SCHIP) income eligibility and the financial burden reported by low-income families raising children with special health care needs (CSHCN). SAMPLE AND METHODS: Data on low-income CSHCN and their families were from the National Survey of Children With Special Health Care Needs (N = 17039), with a representative sample from each state. State Medicaid and SCHIP income-eligibility thresholds were from publicly available sources. The 3 outcomes included whether families had any out-of-pocket health care expenditures during the previous 12 months for their CSHCN, amount of expenditure, and expenditures as a percentage of family income. We used multilevel logistic regression to model the association between Medicaid and SCHIP characteristics and families' financial burden, controlling state median income and child- and family-level characteristics. RESULTS: Overall, 61% of low-income families reported expenditures of >$0. Among these families, 30% had expenses between $250 and $500, and 34% had expenses of more than $500. Twenty-seven percent of the families reporting any expenses had expenditures that exceeded 3% of their total household income. The percentage of low-income families with out-of-pocket expenses that exceeded 3% of their income varied considerably according to state and ranged from 5.6% to 25.8%. Families living in states with higher Medicaid and SCHIP income-eligibility guidelines were less likely to have high absolute burden and high relative burden. CONCLUSIONS: Beyond child and family characteristics, there is considerable state-level variability in low-income families' out-of-pocket expenditures for their CSHCN. A portion of this variability is associated with states' Medicaid and SCHIP income-eligibility thresholds. Families living in states with more generous programs report less absolute and relative financial burden than families living in states with less generous benefits.

Paper brief

Loading…

Cite this work

Citation unavailable for this work.

BibTeX RIS CSL-JSON

No public copy is stored for this record, so only the metadata is cited.

Citations in this library

Citation map →

Stored only when both papers are in the corpus — 67 citations exist upstream.

References

1983A Comparison of Alternative Models for the Demand for Medical Care 1998Understanding the context of healthcare utilization: assessing environmental and provider-related variables in the behavioral model of utilization.2002Health Insurance Coverage in the United States 2005Income, Poverty, and Health Insurance Coverage In The United States: 2004 2005A National Profile of Health Care Utilization and Expenditures for Children With Special Health Care Needs 2004Health Services Use and Health Care Expenditures for Children With Disabilities 2005Financial Burden for Families of Children with Special Health Care Needs 2004Economic Implications of Caregiving at Midlife: Comparing Parents With and Without Children Who Have Developmental Disabilities

Cited by

2011The Employment and Financial Effects on Families Raising Children With Special Health Care Needs: An Examination of the Evidence

Explore the map →

Papers that cite the same references — the relational fallback while embeddings are still backfilling.

Imported from OpenAlex (CC0) — nothing here is generated.