View Research by Author - Patricia Barreto

Publications

Children enrolling for a medical reason in Healthy Kids reported a range of common conditions including allergies, anemia, asthma, cough/cold, stomach problems, and ear/eye infection as their reason for enrollment. A large portion (67%) of parents report enrolling because the child needed prescription medication the family could not afford. Enrollment was associated with improved access to health care and lower out-of-pocket costs. However, families of children enrolled for a medical reason faced persistent barriers in accessing sub-specialty care and demonstrated higher use of emergency department services compared to those not enrolled for a medical reason. Los Angeles, CA: University of California – Los Angeles. May 2009.

Enrollment in Healthy Kids is associated with some improvement in eliciting parent concerns and providing health education, but participation did not increase information for parents about their concerns or affect the proportion of children for whom parents have some type of concern regarding learning, development or behavior. The lack of improvement in these areas despite enrollment in a medical insurance program likely results from larger systems-level barriers to adequate developmental assessment/monitoring and anticipatory guidance within primary care. Findings suggest these barriers such as time, competing demands, and incentives in primary care are not reduced simply by enrollment in health insurance. Los Angeles: University of California at Los Angeles. September 2009.

This brief examines rates of ED visits associated with ACSC diagnoses in the first few years of Healthy Kids (2005-06). Low rates of ED use for ACSC suggest that high use is not a major problem among program enrollees. The rate of ACSCs as a proportion of ED visits also did not decline over the study period, suggesting that while the Healthy Kids evaluation shows an impact upon perceived access to care and affiliation with a primary care provider, the expansion may not have a significant impact upon relatively rare events, such as pediatric hospital stays and ED visits.

The Los Angeles Healthy Kids program, during its first four years, extended comprehensive, affordable coverage to over 40,000 poor and vulnerable children, and improved their access to and use of care. Yet, the program also faced serious challenges, primarily related to financing. Funding for children ages 6 through 18 ran short in spring 2005 and Healthy Kids capped their enrollment. State health reform efforts that could have stabilized funding for the program have failed. Based on interviews with over 40 stakeholders, this case study analyzes the complex challenges that the Los Angeles Healthy Kids program faces at this critical juncture. Washington, DC: The Urban Institute. November 2009.

A second series of focus groups with parents of children enrolled in the Los Angeles Healthy Kids program found that opinions of the program remain favorable despite its recent fiscal challenges. Healthy Kids had provided comprehensive, affordable coverage to nearly 45,000 poor children from birth through age 18 until mid-2005, but funding shortfalls led the program to cap enrollment for older children and enrollment levels for all children subsequently slipped. Still, the program remains highly valued by parents for providing high quality, comprehensive coverage and parents report good access to linguistically appropriate care and affordable out-of-pocket costs.

The Los Angeles Healthy Kids program, during its first four years, extended comprehensive, affordable coverage to over 40,000 poor and vulnerable children, and improved their access to and use of care. Yet, the program also faced serious challenges, primarily related to financing. Funding for children ages 6 through 18 ran short in spring 2005 and Healthy Kids capped their enrollment. State health reform efforts that could have stabilized funding for the program have failed. Based on interviews with over 40 stakeholders, this case study analyzes the complex challenges that the Los Angeles Healthy Kids program faces at this critical juncture.

The Los Angeles Healthy Kids program, during its first four years, extended comprehensive, affordable coverage to over 40,000 poor and vulnerable children, and improved their access to and use of care. Yet, the program also faced serious challenges, primarily related to financing. Funding for children ages 6 through 18 ran short in spring 2005 and Healthy Kids capped their enrollment. State health reform efforts that could have stabilized funding for the program have failed. Based on interviews with over 40 stakeholders, this case study analyzes the complex challenges that the Los Angeles Healthy Kids program faces at this critical juncture.

The Los Angeles Healthy Kids program was created in 2003 to provide health insurance to uninsured children ages 0–5 years in families with household income below 300 percent of the federal poverty level (FPL) who are ineligible for SCHIP or Medicaid. A quality of care survey sampled parents of 538 children ages 12–72 months enrolled in the program for at least one year. Results show that quality of preventive care for children in Healthy Kids has similar patterns as care for children in low-income households, both in California and nationally. Content of preventive care is well below American Academy of Pediatrics (AAP) recommendations, although it is consistent with statewide and national levels of care.

A series of focus groups with parents of children enrolled in the Los Angeles County Healthy Kids program found that the program is providing families with a highly valued service in the form of comprehensive health insurance coverage, permitting their children easier access to care, making health services more affordable, and increasing options for where and when to obtain care. The groups explored parents' feelings about and experiences with Healthy Kids, which extends coverage to uninsured children from birth through age 18 in families with income below 300 percent of the federal poverty level who are ineligible for Medicaid or SCHIP.

A series of focus groups with parents of children enrolled in the Los Angeles County Healthy Kids program found that the program is providing families with a highly valued service in the form of comprehensive health insurance coverage, permitting their children easier access to care, making health services more affordable, and increasing options for where and when to obtain care. The groups explored parents' feelings about and experiences with Healthy Kids, which extends coverage to uninsured children from birth through age 18 in families with income below 300 percent of the federal poverty level who are ineligible for Medicaid or SCHIP.

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