Surprising findings on Medicaid kids ...( BALTIMORE Across the country more chi...),Health

BALTIMORE Across the country, more children are going to hospital emergency rooms than ever, and many of their ER visits are for non-urgent conditions. And national data show that children insured under Medicaid are more likely to visit the ER than children insured privately. But Michigans shift to providing Medicaid through managed care plans may be helping reverse some trends in primary and ER care, narrowing the gaps between Medicaid kids and privately insured ones.

These conclusions are drawn from a trio of new studies by researchers at the University of Michigan Health System, which will be presented here May 7 at the annual meeting of the Pediatric Academic Societies. The Michigan results have implications for states across America, as they grapple with challenges, costs and changes in the Medicaid system.

The studies looked at the number of ER visits by children covered by Medicaid and private insurance, the urgency of their injury or illness, the appropriateness of their visiting the ER, and characteristics of their primary care, such as whether they had a regular doctor and whether they were referred to the ER by a doctor's office. The research was funded by the Michigan Department of Community Health, which runs the state Medicaid system, through an ongoing contract with the U-M Child Health Evaluation and Research, or CHEAR, Unit.

"Our data confirmed some of the trends that have been suspected, such as the use of the ER for non-urgent care, but some of our findings challenge common perceptions," says CHEAR research investigator Sarah J. Clark, M.P.H., senior author on the three studies. "For instance, because the shift to managed care has increased the number of Medicaid kids who have a primary care doctor or clinic to go to, or for their parents to consult about illnesses, they don't always have to rely on the ER as the first and only option. Their patterns of care are getting closer to what we see among children with private in
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Contact: Kara Gavin
umhsmedia@umich.edu
734-764-2220
University of Michigan Health System
7-May-2002

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