Original ArticleParent caregiver-related predictors of health care service utilization by children with cerebral palsy enrolled in Medicaid*,**,*,**,*,**
Section snippets
Objectives
This study was designed to be an exploratory empiric analysis of parent caregiver-related factors associated with health care service utilization and charges by children with cerebral palsy enrolled in Medicaid. The associations between select demographic and behavioral characteristics of the parent caregiver and the health care service utilization and charges by children with cerebral palsy receiving Medicaid coverage were examined.
Study population
The subjects of this study were parent caregivers of children with cerebral palsy who were obtaining medical care from the Wake Forest University Medical Center and whose primary insurance coverage provider for the child was North Carolina Medicaid. In 1995 and 1996, a questionnaire administered to parent caregivers of these children collected detailed information about the demographic and behavioral characteristics of the parent. The parents included in this study were all mothers. The survey
Results
The descriptive statistics of the study population of children with cerebral palsy enrolled in Medicaid who were receiving care from the medical center (Table 1) showed striking similarities in health care service utilization to that of similar populations of children with other chronic conditions enrolled in Medicaid (Ireys et al., 1997).Variables Mean (SD) [median] % Predictor variables Age of the child (y) 5.3 (3.5) [4.6] Caucasian race 76
Summary and discussion
The study found that two behavioral factors associated with the parent caregiver were most predictive of health care service utilization by children with cerebral palsy enrolled in Medicaid: willing use of supplemental health care services for the child (such as home nursing and respite services), and perception of adequate care. The parent's willingness to use supplemental health care services for the child was associated with an increase in the use of health care services (such as inpatient
Conclusion
Evidence seems to suggest that different perceptions of parent caregivers are associated with the variations in health care service utilization and charges by children with cerebral palsy who are enrolled in Medicaid. The reduction of these differences across parent caregivers could be an important factor in ensuring availability of comprehensive treatment and care management for these children.
References (13)
- et al.
Care-load for children and young adults with severe children palsy
Developmental Medicine & Child Neurology
(1992) Consumer price index summary [On-line]
Statistical power analysis for the behavioral sciences
(1972)Econometric analysis
(1997)- et al.
Expenditures for care of children with chronic illnesses enrolled in the Washington State Medicaid Program, fiscal year
Pediatrics
(1997) Families' experiences of caring at home for a technology-dependent child: A review of the literature
Child Care Health Development
(1998)
Cited by (14)
Systematic review of the economic impact of cerebral palsy
2018, Research in Developmental DisabilitiesCitation Excerpt :After controlling for clinical and sociodemographic confounders, severe neurodevelopment impairment increased health and social service costs by an average of US$2483 over a 12-months period (Petrou et al., 2013). A survey in a US hospital collected information from 93 parents of children with CP who maintained 1 year of continuous Medicare enrolment (Balkrishnan et al., 2002). The annual costs associated with health care service use was US$3250 for inpatient hospitalization, US$1214 for outpatient services, US$3280 for orthopaedic services, and US$3549 for home nursing charges.
Using Palliative Care in Progressive Neuromuscular Disease to Maximize Quality of Life
2012, Physical Medicine and Rehabilitation Clinics of North AmericaCitation Excerpt :Yet service use models typically explain no more than 25% of the variance, whether predicting the use of individual services or the total number of services. Prior studies have shown considerable variance in other disabled patient populations in terms of use of palliative care services.25–29 Family resources should not serve as barriers to palliative care services because insurance should cover most of these costs.
Assessment of families of children with cerebral palsy of the "cP-graph on treatment modalities for gross motor function"
2012, European Journal of Paediatric NeurologyThe updated European Consensus 2009 on the use of Botulinum toxin for children with cerebral palsy
2010, European Journal of Paediatric NeurologyEuropean consensus table 2006 on botulinum toxin for children with cerebral palsy
2006, European Journal of Paediatric NeurologyEffects of an episode of specialist care on the impact of childhood atopic dermatitis on the child's family
2003, Journal of Pediatric Health CareCitation Excerpt :Improvements in caregiver treatment satisfaction as well as reduction in the impact on the family could have significant implications for outcomes in children with AD. In other chronic conditions such as cerebral palsy, parent/caregiver perceptions have shown to affect both levels of health care services the child receives as well as maintaining the continuum of care (Balkrishnan, Naughton, Manuel, Smith, & Koman, 2002). A parent/caregiver of a child with a chronic condition such as AD serves as an important interface in ensuring receipt of medical care and, in turn, optimal management of disease symptoms and outcomes for the chronically ill child.
- *
Michelle Naughton is Associate Professor at the Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.
- **
Beth P. Smith is Associate Professor at the Department of Orthopedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC.
- *
Janeen Manuel is Research Associate at the Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.
- **
L. Andrew Koman is Professor at the Department of Orthopedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC.
- *
Funded in part by the North Carolina Department of Health and Human Resources, the Cerebral Palsy Foundation, the Orthopedic Research and Education Foundation, and an unrestricted educational grant from Allergan Inc.
- **
Reprint requests: Rajesh Balkrishnan, PhD, Department of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157.