Medical Home and Out-of-Pocket Medical Costs for Children With Special Health Care Needs

作者：Porterfield Shirley L^*; DeRigne LeaAnne

来源：Pediatrics, 2011, 128(5): 892-900.

DOI：10.1542/peds.2010-1307

• health care costs
• out-of-pocket costs
• medical home
• children
• with special health care needs
• insurance

OBJECTIVE: We examined key factors that affect out-of-pocket medical expenditures per $1000 of household income for children with special health care needs (CSHCN) with a broad range of conditions, controlling for insurance type and concentrating on the potentially moderating role of the medical home.
METHODS: A Heckman selection model was used to estimate whether the medical home influenced out-of-pocket medical costs per $1000 of household income for children covered by either private or public health insurance. Data from the 2005-2006 National Survey of CSHCN (N = 31 808) were used.
RESULTS: For families that incurred out-of-pocket medical costs for their CSHCN, these costs represented 2.2% to 3.9% of income. Both insurance type and the medical home had significant effects on out-of-pocket costs. Lower out-of-pocket medical costs per $1000 of income were incurred by children with public insurance and those receiving care coordination services.
CONCLUSIONS: Families with CSHCN incur lower out-of-pocket medical costs when their children receive health care in a setting in which the care-coordination component of the medical home is in place. Pediatrics 2011;128:892-900

• 出版日期2011-11