Abstract:
:Over the past 30 years, there have been major expansions in public health insurance for low-income children in the United States through Medicaid, the Children's Health Insurance Program (CHIP), and other state-based efforts. In addition, many low-income parents have gained Medicaid coverage since 2014 under the Affordable Care Act. Most of the research to date on health insurance coverage among low-income populations has focused on its effect on health care utilization and health outcomes, with much less attention to the financial protection it offers families. We review a growing body of evidence that public health insurance provides important financial benefits to low-income families. Expansions in public health insurance for low-income children and adults are associated with reduced out of pocket medical spending, increased financial stability, and improved material well-being for families. We also review the potential poverty-reducing effects of public health insurance coverage. When out of pocket medical expenses are taken into account in defining the poverty rate, Medicaid plays a significant role in decreasing poverty for many children and families. In addition, public health insurance programs connect families to other social supports such as food assistance programs that also help reduce poverty. We conclude by reviewing emerging evidence that access to public health insurance in childhood has long-term effects for health and economic outcomes in adulthood. Exposure to Medicaid and CHIP during childhood has been linked to decreased mortality and fewer chronic health conditions, better educational attainment, and less reliance on government support later in life. In sum, the nation's public health insurance programs have many important short- and long-term poverty-reducing benefits for low-income families with children.
journal_name
Acad Pediatrjournal_title
Academic pediatricsauthors
Wherry LR,Kenney GM,Sommers BDdoi
10.1016/j.acap.2015.12.011subject
Has Abstractpub_date
2016-04-01 00:00:00pages
S98-S104issue
3 Suppleissn
1876-2859issn
1876-2867pii
S1876-2859(15)00384-8journal_volume
16pub_type
杂志文章abstract:OBJECTIVE:(1) To describe coparenting among adolescent mothers and the biological fathers of their children. (2) To examine the effects of coparenting on young children's social-emotional development and whether these effects vary by father's residence status, parental education, and child characteristics. METHODS:Sec...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2012.07.007
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:To determine if parents' self-efficacy in communicating with their child's pediatrician is associated with African American mothers' disclosure of psychosocial concerns during pediatric primary care visits. METHODS:Self-identified African American mothers (n = 231) of children 2 to 5 years were recruited fro...
journal_title:Academic pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1016/j.acap.2014.03.002
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate training in developmental and behavioral pediatrics (DBP) for graduating residents, their competencies in diagnosing and treating child mental health (MH) problems, and whether the amount of DBP training and/or perceived competencies are associated with perceived respo...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2010.03.003
更新日期:2010-07-01 00:00:00
abstract::This paper provides a primer for qualitative research in medical education. Our aim is to equip readers with a basic understanding of qualitative research and prepare them to judge the goodness of fit between qualitative research and their own research questions. We provide an overview of the reasons for choosing a qu...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2011.05.001
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:Accurate parental weight perception of one's child is an important step in addressing healthy behaviors, but its associations with socioeconomic status (SES) and household food insecurity (HFI) are unclear. We aimed to assess the association of parental weight perception with HFI. METHODS:This was a secondar...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2019.04.009
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the percentage of hospitals with adequate sample size to meaningfully compare performance by using the Agency for Healthcare Research and Quality (AHRQ) pediatric quality indicators (PDIs), which measure pediatric inpatient adverse events such as decubitus ulcer rate and...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2010.04.025
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:The objective of this study is to provide a comprehensive epidemiological profile detailing food allergy (FA) prevalence and related correlates among Medicaid-enrolled children. METHODS:The 2012 Medicaid Analytic eXtract person-level 100% files for 50 states and the District of Columbia were analyzed. The an...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.03.005
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:Almost one-half of all pediatric gastrostomy tube insertions are accompanied by a fundoplication, yet little is understood about the surgical decision-making for these procedures. The objective of this study was to examine the decision-making process of surgeons about whether to perform a fundoplication in ch...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2012.07.006
更新日期:2012-11-01 00:00:00
abstract::Education, like clinical medicine, should be based on the most current evidence in the field. Unfortunately, medical educators can be overwhelmed by the sheer volume and range of resources for this literature. This article provides an overview of 15 articles from 2016 that the authors consider the top articles in the ...
journal_title:Academic pediatrics
pub_type: 杂志文章,评审
doi:10.1016/j.acap.2018.01.015
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:To describe the delivery of well-child care and its components; to compare that delivery with recommendations in Bright Futures; and to compare delivery of well-child care for children with special health care needs with that for children without special needs. METHODS:Over a 10-week period, 2 medical studen...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2010.12.008
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The role of a hospitalist differs in a community hospital (CH) compared to a university/children's hospital. Residents are required to practice in a variety of relevant clinical settings, but little is known about current trends regarding pediatric resident training in different hospital settin...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2019.10.006
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:To examine insurance-based disparities in provider-related barriers to care among children in California in the wake of changes to the insurance market resulting from the Affordable Care Act. METHODS:Our sample included 6514 children (ages 0 to 11 years) from the 2014-2016 California Health Interview Survey....
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2018.09.003
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:Guidelines recommend closer outpatient follow-up for exclusively breastfed newborns, especially those with pronounced weight loss, because of increased risk of hyperbilirubinemia and dehydration that might require readmission. Our objective was to determine how feeding method and weight loss are associated wi...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.11.005
更新日期:2018-08-01 00:00:00
abstract::Primary care pediatricians and psychology practitioners who comanage mental health problems can develop interdisciplinary communication and collaborative skills from joint standardized patient encounters and debriefings, combined with brief didactics. Learners showed increased confidence in shared management of behavi...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.06.014
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Use of complementary and alternative medical (CAM) therapies is common among adults with mental health concerns, but little is known about CAM use among adolescents with mental health concerns. METHODS:Data from the 2007 National Health Interview Survey were analyzed for youth from 7 to 17 years old. The st...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2013.05.001
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:Burnout is a work-related syndrome characterized by emotional exhaustion (EE), depersonalization (DP), and lack of personal accomplishment (PA). We hypothesized that the transition into an environment of high physical, intellectual, and emotional demands of the medical profession would lead to an increase in ...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2013.12.001
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVES:To develop, validate, and test the feasibility of implementation of 4 new quality measures assessing emergency department (ED) and inpatient care for suicidal youth. METHODS:Four quality measures were developed to assess hospital-based care for suicidal youth. These measures, focused on counseling caregiver...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.09.017
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:To examine whether infrequent bullying perpetration and victimization (once or twice a month) are associated with elevated levels of internalizing and externalizing problems and to assess evidence for a minimum frequency threshold for bullying involvement. METHODS:The analytic sample included 128,681 6th, 9t...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2013.02.004
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:Advocates must make decisions about the types of evidence they emphasize when communicating to cultivate support for adverse childhood experience (ACE) prevention policies. This study sought to characterize public perceptions of the persuasiveness of 12 ACE evidence statements and assess differences by ideolo...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.05.031
更新日期:2020-06-15 00:00:00
abstract:OBJECTIVE:To examine the relationship between continuity of care for children with medical complexity (CMC) and emergency department (ED) utilization, care coordination quality, and family effects related to care coordination. METHODS:We measured ED utilization and primary care continuity with the Bice-Boxerman contin...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2018.04.009
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To evaluate how parents and physicians perceive the utility of a comprehensive, electronic previsit screener, and to assess its impact on the visit. METHODS:A mixed methods design was used. English-speaking parents were recruited from 3 primary care systems (urban MD and rural NY and VT) when they presented ...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2013.04.005
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:Dermatologic complaints are common in outpatient pediatrics. However, pediatric dermatology specialty care can be difficult to access. We aimed to test the feasibility of co-locating dermatology services within primary care and increase the proportion of patients treated for basic skin complaints within the m...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.10.005
更新日期:2020-10-15 00:00:00
abstract:OBJECTIVE:Goals of care discussions are crucial in helping parents navigate complex medical decisions and shown to improve quality of care. Little is known about whether physicians elicit or address parents' goals during a child's hospitalization. The purpose of this study was to understand the current practice of goal...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.05.016
更新日期:2020-05-31 00:00:00
abstract:BACKGROUND:Children and adolescents necessitating hospitalization for physical health conditions are at high risk for mental health conditions; however, the prevalence of mental health conditions and symptoms among hospitalized children and adolescents is uncertain. The objective of this study was to determine the prop...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2016.08.009
更新日期:2017-03-01 00:00:00
abstract::Neonatal intensive care unit networks that encompass regions, states, and even entire countries offer the perfect platform for implementing continuous quality improvement initiatives to advance the health care provided to vulnerable neonates. Through cycles of identification and implementation of best available eviden...
journal_title:Academic pediatrics
pub_type: 杂志文章,评审
doi:10.1016/j.acap.2013.04.014
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:To develop a clinical score to predict appendicitis among older, male children who present to the emergency department with suspected appendicitis. METHODS:Patients with suspected appendicitis were prospectively enrolled at 9 pediatric emergency departments. A total of 2625 patients enrolled; a subset of 961...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2016.11.014
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:There has been a rapid increase in the number of pediatric hospitalist programs in the United States. As most pediatric hospitalist services are believed to be subsidized by hospitals, gaining a better understanding of the rationale for these subsidies is critical to the future success and existence of these ...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2009.01.003
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:To evaluate a pediatric otoscopy curriculum with the use of outcome measures that included assessment of skills with real patients. METHODS:Thirty-three residents in an intervention group from 2 institutions received the curriculum. In the previous year, 21 residents in a nonintervention group did not receiv...
journal_title:Academic pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1016/j.acap.2018.02.009
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:Primary care providers (PCPs) and hospitalists endorse the importance of effective communication yet studies illustrate critical communication problems between these 2 provider types. Our objective was to develop deeper insight into the dimensions of and underlying reasons for communication issues and determi...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2016.03.003
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE:To develop and validate a computable phenotype algorithm for identifying patient populations with sickle cell disease. METHODS:In this retrospective study we used electronic health record data from the Children's Hospital of Wisconsin to develop a computable phenotype algorithm for sickle cell disease. The a...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2016.12.005
更新日期:2017-04-01 00:00:00