Factors associated with pediatricians' participation in Medicaid in North Carolina

Article Abstract:

Pediatricians in small towns who have a tolerant attitude towards Medicaid patients, and who understand the Medicaid payment system may be more likely to treat Medicaid patients than other pediatricians in North Carolina. Of 332 pediatricians, 29% limited the number of Medicaid patients treated in their practice. Sixty-two percent of pediatricians in cities, 13% in middle-sized towns, and 12% in small towns limited treatment of Medicaid patients. Pediatricians who had an unfavorable attitude towards the Medicaid bureaucracy and Medicaid recipients were less likely to accept Medicaid patients than other pediatricians. Forty-three percent of pediatricians who limited treatment of Medicaid patients underestimated payment for Medicaid patients, compared to only 24% of those who did not limit treatment of Medicaid patients. Pediatricians who were paid a higher proportion of their usual fee from Medicaid were more likely to treat Medicaid patients than those who received a lower proportion.

Practice, North Carolina, Medicaid, Pediatricians

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The rest of the access-to-care puzzle: addressing structural and personal barriers to health care for socially disadvantaged children

Article Abstract:

Personal and structural barriers that prevent the children of disadvantaged families from seeing a doctor must be eliminated. Low reimbursement rates and time-consuming paper work in billing Medicaid discourage doctors from accepting Medicaid patients. Sick-child, well-child, and preventative care are often not provided by the same person, which compromises continuity and coordination of care and therefore quality of care. Medicaid families often need more intensive services and a greater variety of services than is provided by health maintenance organization structures. Personal barriers include parental ignorance about the importance of preventative care, inconvenient office hours for working mothers, lack of child care for siblings, and language barriers. Integrated, community-based approaches, teamwork within the practice, and coordination between doctors and health departments would help to overcome personal and structural barriers to health care access.

Care and treatment, Medical care, Poor children, Medical care needs assessment

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Linking clinical and public health approaches to improve access to health care for socially disadvantaged mothers and children

Article Abstract:

Poor pregnant women who receive special attention encouraging them to seek pediatric care for their newborns may be more likely to obtain preventive and primary care for their infants. Researchers studied 93 Medicaid-eligible pregnant women in their third trimester with their first child to find out if special encouragement in doctors' offices or in home visits would result in better care for newborns. Home visits and office attention resulted in better continuity of care, with women seeking care from a primary care practice and experiencing less waiting time.

Evaluation, Services, Community health services, Visiting nurses, Poor women

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