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Barriers to SCHIP enrollment: A cross-county study of the State Children's Health Insurance Program in Pennsylvania

Published online by Cambridge University Press:  17 May 2016

Christina M. L. Kelton ,
Miriam Levitt  and
Margaret K. Pasquale
Christina M. L. Kelton
Affiliation:
College of Business Economics Center for Education & Research University of Cincinnati, 3130 Edwards One Cincinnati, OH 45221-0223, USA [email protected]
Miriam Levitt
Affiliation:
Department of Epidemiology and Community Medicine University of Ottawa ML Health and Social Policy Consulting 502-207 Maclaren Street Ottawa, Ontario K2P OL4 Canada [email protected]
Margaret K. Pasquale
Affiliation:
Epidemiology & Pharmacoeconomics P & G Pharmaceuticals, Inc. 8700 Mason Montgomery Road Mason, OH 45040-9462, USA [email protected]
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Abstract

BACKGROUND. Enrollment in the State Children's Health Insurance Program (SCHIP), created under the federal Balanced Budget Act of 1997, had a distressingly slow start and varied substantially county-to-county in many states, including Pennsylvania.

METHODS. We performed a quantitative county-level analysis of barriers to enrollment in Pennsylvania's Children's Health Insurance Program (CHIP) for the year 2000, seven years after it was implemented and three years after federal SCHIP legislation. Using multivariate regression analysis with a county as the unit of observation, we modeled enrollment in SCHIP as a function of accessibility to health care, availability of clinicians, and community economic health.

RESULTS. High clinic density and Medicaid managed-care membership predicted SCHIP enrollment success, while female head-of-household predicted SCHIP enrollment failure. A principal-components factor analysis revealed four underlying barriers to enrollment: accessibility, availability, affordability, and effort.

CONCLUSIONS. The most formidable barriers to SCHIP enrollment success in Pennsylvania were not programmatic; they were correlates of poverty itself.

Type
Research Article
Information
Politics and the Life Sciences , Volume 24 , Issue 1-2 , September 2005 , pp. 22 - 31
Copyright
Copyright © Association for Politics and the Life Sciences 

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