The State Children's Health Insurance Program: A Multicenter Trial of Outreach Through the Emergency Department

• Published in: American journal of public health (1971) Vol. 95; no. 2; pp. 250 - 253
• Main Authors: Gordon, James A, Emond, Jennifer A, Camargo, Carlos A., Jr
• Format: Journal Article
• Language: English
• Published: Washington, DC Am Public Health Assoc 01.02.2005; American Public Health Association; American Journal of Public Health 2005
• Subjects: Bilingual materials; Biological and medical sciences; Case-Control Studies; Child; Child Health Services - economics; Child Health Services - organization & administration; Childrens health insurance programs; Community-Institutional Relations; Eligibility Determination; Emergency medical care; Emergency medical services; Emergency Service, Hospital - organization & administration; Emergency Service, Hospital - utilization; Enrollments; Female; Forms and Records Control; Health insurance; Health maintenance organizations; HMOs; Hospitals; Humans; Information Services; Insurance applications; Insurance coverage; Intervention; Male; Medicaid; Medical sciences; Medically Uninsured; Minority Groups; Miscellaneous; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Research and Practice; State Health Plans - organization & administration; State Health Plans - utilization; Uninsured people; United States; Welfare; United States; North America; America; United States > US; Human; Health insurance; Sanitary program; Poverty; Emergency department; Multicenter study; Welfare aids; Child; Public health
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2003.037242

Objectives. We evaluated emergency department (ED)–based outreach for the State Children’s Health Insurance Program (SCHIP). Methods. We conducted a multicenter trial among uninsured children (≤ 18 years) who presented to 5 EDs in 2001 and 2002. On-site staff enrolled consecutive subjects for a control period followed by an intervention period during which staff handed out SCHIP applications to the uninsured. The primary outcome was state-level confirmation of insured status at 90 days. Results. We followed 223 subjects (108 control, 115 intervention) by both phone interview and state records. Compared to control subjects, those receiving a SCHIP application were more likely to have state health insurance at 90 days (42% vs 28%; P<.05; odds ratio [OR]=3.8; 95% confidence interval [CI]=1.7, 8.6). Although the intervention effect was prominent among 118 African Americans (50% insured after intervention vs 31% of controls, P<.05), lack of family enrollment in other public assistance programs was the primary predictor of intervention success (OR=3.7; 95% CI=1.6, 8.4). Conclusions. Handing out insurance applications in the ED can be an effective SCHIP enrollment strategy, particularly among minority children without connections to the social welfare system. Adopted nationwide, this simple strategy could initiate insurance coverage for more than a quarter million additional children each year.