Four State Comparison of Access, Utilization and Quality of Care for SSI Adults and Children Final rept

摘要

This report compares the health status, health care utilization and health care experiences of Medicaid-eligible adults and children with Supplemental Security Income (SSI) in specific regions of Kentucky, New York and Tennessee, and in the state of Oregon. Surveys were conducted by RTI International and Mathematica Policy Research in two rural regions of Kentucky, two regions in New York (New York City and Westchester County), Shelby County in Tennessee (which contains Memphis) and the state of Oregon in 1998-2000. Respondents were eligible for SSI due to mental illness, mental retardation/developmental disability, or physical disability. Virtually all SSI recipients are also eligible for Medicaid, so insurance status was similar across states. Analyzing the survey data, we found that adults and children with SSI generally had access to a usual source of care and did receive care from the same source without unreasonable delays, thus indicating a continuity of care for this vulnerable population. However, adults in Kentucky and Tennessee reported high levels of unmet physician need and adults in Kentucky and Oregon reported high levels of unmet need for prescription medications. Children had lower levels of unmet need. Despite similar insurance coverage, regional variation in health care delivery systems and population characteristics still affected health care experiences of SSI recipients.