Description
- Abstract:
- Background and Objectives Previous research has shown that children with Child Protective Services (CPS) involvement have a higher prevalence of special health care needs and are more likely to have a history of fragmented or inadequate health care services. Previous studies have found that many of these children rely on urgent care facilities and the Emergency Department (ED) for the majority of their care. This study aims to assess the relationship between CPS involvement and foster care placement on health care utilization rates in a variety of care settings among children ever enrolled in Medicaid. Methods This retrospective cohort study utilized linked administrative data on children born in Rhode Island between January 1, 2005 and December 31, 2016 who were enrolled in Medicaid at any point during the study period for a minimum of 28 days. The study sample included 100,805 children. Bivariate analyses were performed to evaluate the characteristics associated with foster care involvement for children with CPS involvement in Rhode Island. Paired t-tests were used to evaluate the temporal relationship of health care utilization rates by visit type in the 30 days and 180 days pre-and post-foster care placement for those in foster care. Results Children with CPS involvement, regardless of foster care status, are more likely to receive services from urgent care facilities (20.2 vs. 13.2; p<.0001) and the ED (74.3 vs. 62.0; p<.0001), and to have an inpatient admission (12.0 vs. 8.9; p<.0001), compared to their non-CPS involved peers. Children with CPS involvement also have fewer primary care visits (259.5 vs. 349.8; p<.0001) than their non-CPS involved peers. For children with foster care involvement, primary care visits increased at both 30- and 180-days post-foster care placement, while ED visits and inpatient admissions both decreased. Conclusion This study suggests that children with CPS involvement, regardless of foster care status, are at increased risk of relying on urgent care and ED facilities for health care services and are less likely than their non-CPS involved peers to have a primary care visit. More guidelines are needed to establish a usual source of care for these children and to facilitate routine primary care visits.
- Notes:
- Thesis (M. P. H.)--Brown University, 2021
Citation
White, Caitlyn,
"Child Protective Services Involvement and Health Care Utilization Rates Among Medicaid Enrolled Children"
(2021).
Public Health Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://repository.library.brown.edu/studio/item/bdr:gjn2qyjp/
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Public Health Theses and Dissertations
Theses and Dissertations for the Public Health department....