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Increased Access to Healthcare for Children Leads to Decreased Hospitalization

July 15, 2002

Study published in the Archives of Pediatrics and Adolescent Medicine suggests that the decline in hospitalization rates observed in Washington state Medicaid children may be the result of many statewide efforts to increase access and improve management for this population.

Study published in the Archives of Pediatrics and Adolescent Medicine suggests that the decline in hospitalization rates observed in Washington state Medicaid children may be the result of many statewide efforts to increase access and improve management for this population.

Seattle, Wash. - As state government grapples with burgeoning health care costs and works to address its budget shortfalls in a slow economy, a study published in the July issue of Archives of Pediatrics and Adolescent Medicine suggests a direct link between access to medical care for children and declines in expensive hospitalization rates for children.

The study was published by John Neff, MD, director of the Center for Children With Special Needs at Children’s Hospital and Regional Medical Center and professor of pediatrics at the University of Washington School of Medicine, and other authors in collaboration with the National Association of Children’s Hospitals and Related Institutions (NACHRI) in Alexandria, Va.

The study shows a pronounced decrease in total hospitalization rates for Medicaid-enrolled children aged 0-17 years in Washington state from 1991 to 1998. This trend is not as significant for non-Medicaid children. Washington state made major strides between 1989 and 1995 to improve access to medical care for uninsured and Medicaid-eligible children. These efforts included:

  1. An increase in enrollment of Medicaid for children by increasing the income eligibility from less than 100% of the Federal Poverty Level to 200%.
  2. An increase in reimbursement to health care providers for fee-for-service primary care visits.
  3. Medicaid recipients were enrolled in Healthy Options Plan, a managed care plan, and assigned to a primary care provider.

    As a result of these policy initiatives, the number of Medicaid enrollees nearly doubled in Washington state and up to 80 % were assigned to a primary care provider, many for the first time. Even with these increases in the Medicaid population annual hospitalizations of children actually decreased. Almost all of these decreases were in Medicaid children.

“This study strongly suggests that improved access to primary care, the least expensive form of health care, reduces hospitalization – the most expensive form of health care. It also suggests that these same gains are stabilizing; a higher percentage of those children now hospitalized have chronic conditions and caring for these children is more costly. As a result, there may not be such remarkable savings in the future. However, legislative or administrative efforts that decrease access to primary care could return us to high rates of hospitalizations and increase Medicaid costs. This data is very timely in states that are facing significant budget crises,” says Dr. John Neff.

“It is a very basic concept that easy access to primary health care for children not only saves money but is the right thing to do for children and their families. It is great to have these important associations documented for the state of Washington,” says Dr. Richard Molteni, medical director and vice president of Children’s Hospital.

“When pressed with budget reductions, it is imperative that states continue their efforts to be sure that every child is assigned to a primary care practitioner and supported with adequate health insurance,” says Lawrence A. McAndrews, president and CEO of NACHRI.

“We are very proud of the accomplishments in Washington state to improve access to healthcare for children,” says Treuman Katz, president and CEO of Children’s in Seattle. “Providing healthccare for children is not causing the budget crisis in Washington, and reducing access to medical care for children will only make matters worse.”

About Seattle Children’s

Consistently ranked as one of the best children’s hospitals in the country by U.S. News & World Report, Seattle Children’s serves as the pediatric and adolescent academic medical referral center for the largest landmass of any children’s hospital in the country (Washington, Alaska, Montana and Idaho). For more than 100 years, Seattle Children’s has been delivering superior patient care while advancing new treatments through pediatric research. Seattle Children’s serves as the primary teaching, clinical and research site for the Department of Pediatrics at the University of Washington School of Medicine. The hospital works in partnership with Seattle Children’s Research Institute and Seattle Children’s Hospital Foundation. For more information, visit www.seattlechildrens.org or follow us on Twitter or Facebook.

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