Pediatric access to dermatologists: Medicaid versus private insurance

Chaudhry, Sofia; Armbrecht, Eric S.; Shin, Yoon Kyung; Matula, Sarah; Caffrey, Charles; Varade, Reena; Jones, Lisa; Siegfried, Elaine C.

doi:10.1016/j.jaad.2012.10.034

Cited by 60 publications

(54 citation statements)

References 14 publications

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“…Also, like adults, pediatric patients with Medicaid/CHIP have been shown to have problems with access to both primary care and specialty care when compared to patients with private insurance . Healthcare utilization patterns for pediatric patients with ARS, however, have not been specifically characterized; it is not known if pediatric utilization patterns mirror those of adults . It also is not known whether patients with public insurance or no insurance use more or less care overall than the privately insured population.…”

Section: Introductionsupporting

confidence: 87%

“…Subspecialty care also has been shown to be more limited for children with Medicaid, with a high proportion of offices refusing to see Medicaid patients and long wait times for offices that do accept Medicaid patients . This trend has been corroborated in other specialties, for example, dermatology . Medicaid also has been associated with poorer outcomes in children, such as poorer asthma control .…”

Section: Discussionmentioning

confidence: 54%

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Emergency department use for acute rhinosinusitis: Insurance dependent for children and adults

et al. 2017

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Section: Introductionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 54%

Emergency department use for acute rhinosinusitis: Insurance dependent for children and adults

et al. 2017

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“…33 Similar results have been found in national "secret shopper" surveys evaluating Medicaid patients' access to orthopedic and dermatology care. 34,35 The most common diagnoses for pediatric visits to EDs include fever, ear infections, the common cold, and minor injuries, 36 illnesses that are amenable to treatment by primary care providers. In addition, asthma and intestinal viruses-examples of ambulatory care-sensitive conditions 37 -are also among the top diagnoses.…”

Section: Barriers To Access For the Underinsuredmentioning

confidence: 99%

Emergency Care For Children In The United States

2013

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A formal emergency care system for children in the United States began in the 1980s with the establishment of specialized training programs in academic children's hospitals. The ensuing three decades have witnessed the establishment of informal regional networks for clinical care and a federally funded research consortium that allows for multisite research on evidence-based practices. However, pediatric emergency care suffers from problems common to emergency departments (EDs) in general, which include misaligned incentives for care, overcrowding, and wide variation in the quality of care. In pediatric emergency care specifically, there are problems with low-volume EDs that have neither the experience nor the equipment to treat children, poor adherence to clinical guidelines, lack of resources for mental health patients, and a lack of widely accepted performance metrics. We call for policies to address these issues, including providing after-hours care in other settings and restructuring payment and reimbursement policies to better address patients' needs.

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“…For instance, because of changing reimbursement models, it is substantially harder for Medicaid and uninsured patients to have their dermatologist visits covered 21. Indeed, a study surveying Medicaid-listed dermatology offices observed that 44% of practices could not see a new Medicaid-insured pediatric patient 22. However, Medicaid and uninsured status were risk factors for being hospitalized, which further reinforces the importance of all patients having access to regular dermatologic care.…”

mentioning

confidence: 99%