Medicaid, the federal health care program for low-income families and many children with disabilities, also insures most children living in foster care. As a result, "most prior studies that estimated health service use by children in foster care used Medicaid records as their source of information," said the study's lead author, David Rubin, M.D., M.S.C.E., director of Research and Policy for Safe Place: The Center for Child Protection and Health at The Children's Hospital of Philadelphia. "The problem we found is that Medicaid records fail to identify many foster care children, especially those who may not have been receiving medical services they needed."
The study appeared in the May-June issue of Ambulatory Pediatrics.
The research team studied Medicaid eligibility files for a sample of 5,683 children who entered foster care in Philadelphia during 1994 and 1995. They found that the Medicaid system failed to identify 28 percent of the children as residing in foster care. "We found a systematic sampling bias," said Dr. Rubin. "Children were more likely to be identified correctly as foster children if they had a greater number of foster care placements or used more services, such as hospital emergency departments or mental health programs."
"However, we found that nearly 40 percent of the children in our sample never visited an outpatient health care or mental health provider during the year after they were placed in foster care," added Dr. Rubin. "Many of these children were among those not identified by Medicaid as living in foster
Contact: Rachel Salis
Children's Hospital of Philadelphia