Health care utilization and spending among privately insured children with medical complexity

Journal of Child Health Care : for Professionals Working with Children in the Hospital and Community
Angela Wangari WalterYiyang Yuan

Abstract

Children with medical complexity have high health service utilization and health expenditures that can impose significant financial burdens. This study examined these issues for families with children enrolled in US private health plans. Using IBM Watson/Truven Analytics℠ MarketScan® commercial claims and encounters data (2012-2014), we analyzed through regression models, the differences in health care utilization and spending of disaggregated health care services by health plan types and children's medical complexity levels. Children in consumer-driven and high-deductible plans had much higher out-of-pocket spending and cost shares than those in health maintenance organizations and preferred provider organizations (PPOs). Children with complex chronic conditions had higher service utilization and out-of-pocket expenditures while having lower cost shares on various categories of services than those without any chronic condition. Compared to families covered by PPOs, those with high-deductible or consumer-driven plans were 2.7 and 1.7 times more likely to spend over US$1000 out of pocket on their children's medical care, respectively. Families with higher complexity levels were more likely to experience financial burdens from ex...Continue Reading

References

Aug 26, 1998·Pediatrics·M McPhersonB Strickland
Apr 1, 2000·Pediatrics·P W NewacheckN Halfon
Jun 21, 2005·Maternal and Child Health Journal·Karen KuhlthauJames M Perrin
Jul 18, 2006·Ambulatory Pediatrics : the Official Journal of the Ambulatory Pediatric Association·Alex Y Chen, Paul W Newacheck
Jan 11, 2007·Pediatrics·Donald P OswaldMelinda B Moore
May 25, 2010·Journal of Child and Family Studies·Lisa C Lindley, Barbara A Mark
Sep 8, 2010·The New England Journal of Medicine·Michael D KoganPeter C van Dyck
Nov 9, 2010·Research in Developmental Disabilities·Nina XiongZhengang Jiao
Nov 9, 2011·Archives of Pediatrics & Adolescent Medicine·Dennis Z KuoPatrick H Casey
Apr 25, 2012·Medical Care·Arlene S Ash, Randall P Ellis
May 23, 2012·International Journal of Health Services : Planning, Administration, Evaluation·Qi CaoKeyong Dong
Nov 7, 2012·Pediatrics·Lauren E Wisk, Whitney P Witt
Nov 28, 2012·Pediatrics·Eyal CohenAstrid Guttmann
Dec 18, 2012·Journal of Child Health Care : for Professionals Working with Children in the Hospital and Community·Elizabeth J ConreyDj Sam Chapman
Dec 18, 2013·International Journal of Public Health·Vincenzo Atella, Joanna Aleksandra Kopinska
May 14, 2014·Pediatrics·Tamara D SimonUNKNOWN Center of Excellence on Quality of Care Measures for Children with Complex Needs (COE4CCN) Medical Complexity Working Group
Dec 10, 2014·Health Affairs·Jay G BerryChris Feudtner
Apr 10, 2015·Population Health Management·Kristin R BaughmanSharon K Hull
Jun 2, 2015·The Journal of Pediatrics·Jay G BerryChris Feudtner
Oct 27, 2016·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·K P M van WinssenW P M M van de Ven
Jan 2, 2016·Journal of Racial and Ethnic Health Disparities·Jacqueline C WiltshireJeroan J Allison
Oct 27, 2016·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Jessica M GoldJay G Berry
Jul 28, 2016·The Journal of Pediatrics·Titus ChanTamara D Simon
Nov 10, 2017·Journal of Child Health Care : for Professionals Working with Children in the Hospital and Community·Anne Elizabeth GlassgowBenjamin Van Voorhees

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