PEDIATRICS Vol. 107 No. 6 June 2001, pp. 1405-1408
Access to Orthopedic Care for Children With Medicaid Versus Private Insurance in California
Received Nov 21, 2000; accepted Feb 20, 2001.
From the Childrens Hospital Los Angeles, University of Southern
California, Keck School of Medicine, Los Angeles, California.
Objective. To compare the
availability of timely orthopedic care to a child with a fractured arm
insured by Medi-Cal (California state Medicaid) and by private
insurance.
Study Design. Fifty randomly chosen offices of orthopedic
surgeons were telephoned with the following scenario: "My 10-year-old
son broke his arm last week during a vacation" followed by a request
for an appointment that week. Each office was called twice with an identical script except for insurance status: once with Medi-Cal and
once with private insurance.
Results. All 50 offices offered an appointment to see the
child with private insurance within 7 days. Only 1 of the same 50 offices offered an appointment to see the child with Medi-Cal within 7 days. Of the offices that would not see a child with Medi-Cal, 87%
were unable to recommend an orthopedic office that accepted Medi-Cal.
Conclusions. Timely access to orthopedic care was
available in 100% of offices polled to a child with private insurance
versus in 2% of offices to a child with Medi-Cal. This is a
significant difference. Lack of timely orthopedic care may result in
poor outcome, ie, if a fracture is not properly aligned in the first
few weeks, a permanent deformity may result. Although causation cannot
be established from this study, we suspect that Medi-Cal reimbursement rates below the cost of office overhead may be of significance. Although federal guidelines require that payments must be sufficient to
enlist enough providers so that services to Medi-Cal recipients are
available to the same extent as those available to the general population, this study finds that that children with Medi-Cal insurance
have significantly less access to timely orthopedic care.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  G. M. Kenney, J. Ruhter, and T. M. Selden Containing Costs And Improving Care For Children In Medicaid And CHIP Health Aff., November 1, 2009; 28(6): w1025 - w1036. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Rouleau, D. E. Feldman, and S. Parent Delay to orthopedic consultation for isolated limb injury: Cross-sectional survey in a level 1 trauma centre Can Fam Physician, October 1, 2009; 55(10): 1006 - 1007.e5. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. E. Bible, R. S. Lee, and G. E. Friedlaender The Need for Increased Access to the U.S. Health-Care System J. Bone Joint Surg. Am., February 1, 2009; 91(2): 476 - 484. [Full Text] [PDF]
|
|
|
|
 |
|
 L. Cuttler and G. M. Kenney State Children's Health Insurance Program and Pediatrics: Background, Policy Challenges, and Role in Child Health Care Delivery Arch Pediatr Adolesc Med, July 1, 2007; 161(7): 630 - 633. [Full Text] [PDF]
|
|
|
|
 |
|
 A. A. Galbraith, D. C. Grossman, T. D. Koepsell, P. J. Heagerty, and D. A. Christakis Medicaid Acceptance and Availability of Timely Follow-up for Newborns With Medicaid Pediatrics, November 1, 2005; 116(5): 1148 - 1154. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. R. Asplin, K. V. Rhodes, H. Levy, N. Lurie, A. L. Crain, B. P. Carlin, and A. L. Kellermann Insurance Status and Access to Urgent Ambulatory Care Follow-up Appointments JAMA, September 14, 2005; 294(10): 1248 - 1254. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Committee on Child Health Financing Medicaid Policy Statement Pediatrics, July 1, 2005; 116(1): 274 - 280. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. C. Wang, M. C. Choe, J. G. Meara, and J. A. Koempel Inequality of Access to Surgical Specialty Health Care: Why Children With Government-Funded Insurance Have Less Access Than Those With Private Insurance in Southern California Pediatrics, November 1, 2004; 114(5): e584 - e590. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Roye and M. G. Vitale Trauma research aims to facilitate prevention, improve care AAP News, September 1, 2004; 25(3): 124 - 124. [Full Text] [PDF]
|
|
|
|
|
|
M. S. Kocher, J. A. Bishop, B. Weed, M. T. Hresko, M. B. Millis, Y. J. Kim, and J. R. Kasser Delay in Diagnosis of Slipped Capital Femoral Epiphysis Pediatrics, April 1, 2004; 113(4): e322 - e325. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. D. Mulla and C. E. Margo Hospitalization for Nontraumatic Disorders of the Eye and Ocular Adnexa: Analysis of the Florida Agency for Health Care Administration Data Set Arch Ophthalmol, February 1, 2004; 122(2): 262 - 266. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. K. Iglehart The Dilemma of Medicaid N. Engl. J. Med., May 22, 2003; 348(21): 2140 - 2148. [Full Text] [PDF]
|
|
|
|
|
|
A. A. Galbraith, S. A. Egerter, K. S. Marchi, G. Chavez, and P. A. Braveman Newborn Early Discharge Revisited: Are California Newborns Receiving Recommended Postnatal Services? Pediatrics, February 1, 2003; 111(2): 364 - 371. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Saroff, B. Burns, and A. Sarmiento Objectivity and Worldly Wisdom: Missing Ingredients in Orthopaedic Training and Practice J. Bone Joint Surg. Am., January 17, 2003; 85(1): 165 - 166. [Full Text] [PDF]
|
|
