The impact of the Children's Health Insurance Program and health professional shortage areas on South Carolina children.

摘要

ospital emergency departments (ED) have historically been used as the primary source of medical treatment for the poor and underserved, who often seek treatment for conditions normally maintained through primary care. The use of the ED to obtain medical treatment often costs more than treatment in primary care settings, utilizes valuable ED staff and resources, and is less effective when used in lieu of regular preventive care (Martin, 2000). The State Children's Health Insurance Program (CHIP) is designed to address some of these issues. Using effect theory as a framework, this study presents a program evaluation of South Carolina's CHIP. The impact of CHIP on children health was evaluated, as measured by hospitalizations for ambulatory care sensitive conditions (ACSC) from 1996 (pre-implementation) through 2006. This study examined trends in ED visits and hospitalizations for ACSC, the relationship between health professional shortage areas (HPSA) and ED visits for ACSC, as well as associations between urban or rural residency status, HPSA, and ED visits. Results show that ACSC ED visits were more common among children living in counties with median incomes of