The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index; 4 of the 32 sources its claims cite were checked for support.
Auditing Access to Specialty Care for Children with Public Insurance
Open accessAbstract
BACKGROUND: Health care reform has expanded eligibility to public insurance without fully addressing concerns about access. We measured children's access to outpatient specialty care to identify disparities in providers' acceptance of Medicaid and the Children's Health Insurance Program (CHIP) versus private insurance. METHODS: Between January and May 2010, research assistants called a stratified, random sample of clinics representing eight specialties in Cook County, Illinois, which has a high proportion of specialists. Callers posed as mothers of pediatric patients with common health conditions requiring outpatient specialty care. Two calls, separated by 1 month, were placed to each clinic by the same person with the use of a standardized clinical script that differed by insurance status. RESULTS: We completed 546 paired calls to 273 specialty clinics and found significant disparities in provider acceptance of Medicaid-CHIP versus private insurance across all tested specialties. Overall, 66% of Medicaid-CHIP callers (179 of 273) were denied an appointment as compared with 11% of privately insured callers (29 of 273) (relative risk, 6.2; 95% confidence interval [CI], 4.3 to 8.8; P<0.001). Among 89 clinics that accepted both insurance types, the average wait time for Medicaid-CHIP enrollees was 22 days longer than that for privately insured children (95% CI, 6.8 to 37.5; P=0.005). CONCLUSIONS: We found a disparity in access to outpatient specialty care between children with public insurance and those with private insurance. Policy interventions that encourage providers to accept patients with public insurance are needed to improve access to care.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
An audit study of pediatric specialty clinics in Cook County, Illinois, found that callers posing as mothers of publicly insured children were much more likely to be denied appointments than callers reporting private insurance. Even when appointments were offered, publicly insured children waited substantially longer.
Key findings
- Among 273 specialty clinics and 546 paired calls, 66% of Medicaid-CHIP callers (179 of 273) were denied an appointment versus 11% of privately insured callers (29 of 273) (relative risk, 6.2; 95% CI, 4.3 to 8.8; P<0.001).
- Disparities were significant across all tested specialties; in matched-pair analysis, 155 discordant pairs (57%) accepted privately insured children but not Medicaid-CHIP enrollees, versus 5 pairs (2%) with the reverse pattern (odds ratio for denial with public insurance, 31.0; 95% CI, 13.0 to 96.8).
- Among 89 clinics that accepted both insurance types, children with public insurance waited an average of 42 days for an appointment versus 20 days for privately insured children (mean difference, 22.1 days; 95% CI, 6.8 to 37.5; P=0.005).
Methods
- Audit study conducted January through May 2010 in Cook County, Illinois, using trained callers posing as mothers of pediatric patients with common conditions requiring outpatient specialty care.
- A stratified random sample of clinics representing eight specialties was called twice by the same caller, separated by 1 month, with only insurance status varied: Illinois Medicaid-CHIP versus Blue Cross Blue Shield private insurance.
- Outcomes were appointment scheduling and wait time; analyses used relative risks, McNemar’s test for paired calls, exact conditional logistic regression for specialty subanalyses, and paired t-tests for wait-time differences.
Limitations
- The paper states caution in generalizing beyond the specific specialties and region audited, notes no evidence about inpatient or rural pediatric specialists, and says the study was not powered to identify specific provider or clinic characteristics associated with denials or delays.
- The paper also states it did not identify causes of interspecialty variation, did not assess cognitive versus procedural/surgical specialists, and did not determine whether the disparities are clinically meaningful for children’s long-term health and safety.
- The paper notes it assessed only publicly and privately insured children, so access may differ for uninsured children and for adults; evident from the design, the findings are also limited to simulated calls in one urban, specialist-dense county and to one public insurance program and one private insurer.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
4 of 32 cited sources checked · 0 supported · 0 flagged · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Children covered by Medicaid-CHIP may face greater barriers to specialist care as a result of fewer resources within their families, including lower levels of income, education, language proficiency, and health literacy.14”
§ Auditing Access to Specialty Care for Children with Public Insurance > E
What the sources say
- Partly supportedcites [14] sourceExperimental — accuracy not yet measured
The Results (Information and Access to Specialty Health Care Services; page unavailable) report that children in poorer families were less likely to use specialist physician services, and the Discussion links lower income and education to reduced awareness of needed services. But the paper says public and private insurance were equally effective for specialist access; it does not establish greater barriers specifically for Medicaid–CHIP enrollees or assess language proficiency. Lower literacy is mentioned as a possible reason for targeted outreach, not demonstrated as a specialist-care barrier. (LLM, conf=0.88)
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Subsequent studies in which this approach was used did not sufficiently examine physicians' willingness to provide needed specialty care for publicly insured children.7,13,21,22”
§ Auditing Access to Specialty Care for Children with Public Insurance > E
What the sources say
- Not checked — no full text of the sourcecites [7] source
- Not checked — no full text of the sourcecites [13] source
- Partly supportedcites [21] sourceExperimental — accuracy not yet measured
The Abstract and Measurement of Insurance Adequacy section describe a survey-based analysis of children’s insurance and access to specialist care, not an audit study. The paper does not measure physicians’ willingness to treat publicly insured children, but it cannot substantiate the claim about subsequent audit studies as a group. (LLM, conf=0.83)
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We completed 546 paired calls to 273 specialty clinics and found significant disparities in provider acceptance of Medicaid-CHIP versus private insurance across all tested specialties.”
- Also stated in: § Outcomes · plain
“All relative risks (when calculable) and exact conditional logistic-regression analyses showed that, across all tested specialties, children with Medicaid-CHIP were significantly more likely to be denied an appointment than privately insured children.”
- Also stated in: § Discussion · plain
“These results held across all audited specialties.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Outcomes · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“6.2 (4.3-8.8)”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among 89 clinics that accepted both insurance types, the average wait time for Medicaid-CHIP enrollees was 22 days longer than that for privately insured children (95% CI, 6.8 to 37.5; P = 0.005).”
- Also stated in: § Outcomes · plain
“On average, children with public insurance waited 42 days for an appointment with a specialist, whereas privately insured children waited 20 days (mean difference, 22.1 days; 95% CI, 6.8 to 37.5; P = 0.005).”
§ Auditing Access to Specialty Care for Children with Public Insurance > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Outcomes · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Notably, even callers claiming to have a privately insured child faced an average wait time of 20 days when urgently requesting an appointment.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“31.0 (13.0-96.8)”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“However, evidence suggests that the 37 million children covered by Medicaid-CHIP 4,5 are less likely to receive specialty care than children covered by commercial insurance.[6][7][8][9][10][11][12][13]”
§ Auditing Access to Specialty Care for Children with Public Insurance > E
What the sources say
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“However, most studies to date have been unable to directly control for children's clinical need for specialty services.6,18”
§ Auditing Access to Specialty Care for Children with Public Insurance > E
What the sources say
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Audit methodology, traditionally used for detecting “real life” discriminatory behavior in housing and labor markets, can be used to assess insurance-related disparities in health care access.19”
§ Auditing Access to Specialty Care for Children with Public Insurance > E
What the sources say
- Not checked — no full text of the sourcecites [19] source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
- Probably not a substantial claim. 24
- It may state two separate claims as one. 15
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“Sample-size calculations for McNemar's test before the study were based on previous data from audit studies.21 We calculated that a sample of 20 clinics would provide 80% power to detect a 34% difference and that 32 clinics would be needed to detect a 20% difference in the rate of clinics accepting public versus private insurance, at an alpha level of 0.05.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Statistical Analysis
What the sources say
- Could not verifycites [21] sourceExperimental — accuracy not yet measured
The citation is attached to the statement that the sample-size calculations used previous audit-study data; the following sentence presents the power calculations as the citing authors’ own. The cited paper’s Statistical Analysis section describes analyses of a national survey of children, not an audit of clinics, and our copy provides no audit-study data or clinic sample-size calculations (searched for McNemar’s test, clinic acceptance, and the stated power figures). (LLM, conf=0.76)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Could not verify
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“Nor did we assess whether acceptance of public insurance varies between specialists who provide cognitive consultations and procedural or surgical specialists, who may be more dependent on their affiliated hospitals to provide technologically advanced diagnostic and surgical resources.29”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
What the sources say
- Could not verifycites [29] sourceExperimental — accuracy not yet measured
The citing authors’ statement that they did not assess differences between specialist types describes their own study, not the cited paper. The cited paper’s Methods describe a survey of primary care physicians, and its Discussion addresses limitations concerning patient race and insurance status; neither section addresses whether procedural or surgical specialists depend more on affiliated hospitals for advanced resources. Searched for the specialist distinction and hospital-resource dependence. (LLM, conf=0.72)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Could not verify
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, 66% of Medicaid-CHIP callers (179 of 273) were denied an appointment as compared with 11% of privately insured callers (29 of 273) (relative risk, 6.2; 95% confidence interval [CI], 4.3 to 8.8; P<0.001).”
- Also stated in: § Outcomes · plain
“As shown in Table 2, 66% (179) of the callers reporting Medicaid-CHIP coverage were denied an appointment for specialty care, as compared with 11% (29) of the callers reporting Blue Cross Blue Shield insurance (relative risk, 6.2; 95% confidence interval [CI], 4.3 to 8.8; P<0.001).”
§ Auditing Access to Specialty Care for Children with Public Insurance > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Also stated in: § Outcomes · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Relative risks could not be calculated because there were no denials of care for children with private insurance.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“65.6 10.6”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“44.2 (7.9-∞) § | 42.8 (7.6-∞) § | 38.5 (6.8-∞) § | 34.1 (6.0-∞) § | 9.0 (2.2-79.9) | 9.0 (1.2-394.5) | 8.0 (1.9-71.7)”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“In contrast to patient-related or family-related barriers, which are less malleable to change, providerrelated barriers are potentially modifiable through health care policies.16”
§ Auditing Access to Specialty Care for Children with Public Insurance > E
What the sources say
- Not checked — no full text of the sourcecites [16] source
Tests✓ Asserted: passes? Checkable: unclear✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The same caller called the same clinic twice.The order of reported insurance type, the only variable differing between the two calls, was randomly assigned.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Specialty Conditions and Protocol
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Given the association between socioeconomic disadvantage and poor health status, children covered by Medicaid-CHIP may have a greater need for specialty care.17”
§ Auditing Access to Specialty Care for Children with Public Insurance > E
What the sources say
- Not checked — no full text of the sourcecites [17] source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The calls were separated by 1 month and varied only by insurance status (private vs. Medicaid-CHIP insurance).”
§ Auditing Access to Specialty Care for Children with Public Insurance > Data Collection and Study Design
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The study was approved, with a waiver of the requirement for informed consent, by institutional review boards at two institutions, with the caveat that debriefing letters be sent to all clinics in the entire sampling frame at the conclusion of the study.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Study Oversight
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“To control for the racial or ethnic characteristics of a caller's name and voice, all samples were randomly assigned to one of three groups of callers (black, white, or Hispanic) with the use of a computer algorithm.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Specialty Conditions and Protocol
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Using this approach in a 1994 study, the Medicaid Access Study Group found that adult patients with Medicaid had poor access to outpatient care.20”
§ Auditing Access to Specialty Care for Children with Public Insurance > E
What the sources say
- Not checked — no full text of the sourcecites [20] source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“To avoid geographic discrimination, we geocoded all specialty clinics and generated fake patient and PCP addresses that were in the vicinity of (but more than 1.6 km [1 mi] from) each clinic with the use of ArcGIS software (version 9.3).”
§ Auditing Access to Specialty Care for Children with Public Insurance > Specialty Conditions and Protocol
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“the literature indicates that additional variables affect physicians' decisions about whether to accept public insurance, such as delays in payment and hassles of payment procedures, 35,36 personal characteristics of providers (e.g., credentials or experience, 34,38,39 race or ethnic group, 34,[38][39][40][41] and underlying attitudes or prejudices 39,42 ), and structural features of the system in”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
What the sources say
- Not checked — no full text of the sourcecites [35] source
- Not matchedcites [36]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [34] source
- Not matchedcites [38]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [39]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [42]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Standardized responses to questions were prepared through piloting and iterative review to indicate that the conditions were urgent (but not emergencies), common, and warranted specialty care.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“it should be noted that access to specialty care may be different for uninsured children and for publicly insured or uninsured adults.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Each of the 273 clinics was called twice (for a total of 546 calls) by the same caller, with only insurance coverage varying between the two calls: once reporting Medicaid-CHIP coverage and once reporting private coverage.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our results corroborate and add to this important finding by measuring the real-life experience of attempting to schedule an appointment when all other factors besides insurance status (e.g., parental persistence or savvy and the child's clinical symptoms) are held constant.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“the order of the reported insurance status was randomly assigned.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A pilot study of these scripts with standardized responses to possible questions was conducted between November 2009 and January 2010.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Specialty Conditions and Protocol
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In addition, we did not identify the causes of interspecialty variation.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The strength of the current study stems from its ability to isolate the effect of one dimension of access.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Our study only assessed access to specialty care for publicly and privately insured children”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The final sample included all specialists for whom there was any evidence that they provided care to children (0 to 18 years of age) residing in Cook County.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Sampling Methods
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Clinical scenarios (involving a diagnosis and symptoms in a patient of a specified age) were chosen by pediatric primary care providers (PCPs) and specialist consultants with the use of an iterative review process to identify conditions that affect a large number of children, warrant timely outpatient specialty evaluation and treatment to achieve optimal health outcomes, are urgent situations but”
§ Auditing Access to Specialty Care for Children with Public Insurance > Specialty Conditions and Protocol
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We did not test the significance of wait-time disparities by specialty type because of the small number of clinics that scheduled appointments for both insurance types.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Statistical Analysis
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The results showed significant disparities in children's access to needed outpatient specialty care, attributable to specialists' reluctance to accept public health insurance.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We completed 546 paired calls to 273 specialty clinics and found significant disparities in provider acceptance of Medicaid-CHIP versus private insurance across all tested specialties.”
- Also stated in: § Clinics · plain
“Two completed calls were made to each of the remaining 273 clinics (546 total calls).”
§ Auditing Access to Specialty Care for Children with Public Insurance > Abstract
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
- Also stated in: § Clinics · plain
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In particular, there is no evidence that pediatric specialists working in inpatient or rural settings are unwilling to accept Medicaid-CHIP.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Nonetheless, our experimental design affords high internal validity within the context of understanding specialist behavior relative to our simulated children's insurance status, with adequate controls for clinical urgency and other patient-level factors.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“In Illinois, an office consultation visit for a problem of moderate severity (Healthcare Common Procedure Coding System code 99243) is reimbursed at $99.86 by Medicaid-CHIP, 37 whereas the average reimbursement for the same code by a commercial preferred-provider organization is approximately $160.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
What the sources say
- Not matchedcites [37]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Caution is needed in generalizing our results to specialists other than those in the specific specialties and region that were audited in this study.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Because of an extreme split on the dependent variable for orthopedics, asthma, otolaryngology, and dermatology, exact conditional (fixed-effects) logistic-regression odds ratios are medium unbiased estimates with no upper limit of the 95% confidence interval.”
§ Auditing Access to Specialty Care for Children with Public Insurance > Discussion
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
The paper relies on this without support.
Research on children's access to specialty care has not adequately distinguished between provider-related barriers and patient-related ones.
“To date, research on children's access to specialty care has not adequately distinguished between provider-related barriers and patient-related ones.”
Citations
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Supporting the Health Care Transition From Adolescence to Adulthood in the Medical Home
White, P. H., Cooley, W. C., & TRANSITIONS CLINICAL REPORT AUTHORING GROUP, A. A. O. P. (2018) · Pediatrics · doi:10.1542/peds.2018-2587 · Cited by 1,417
The State of Research on Racial/Ethnic Discrimination in The Receipt of Health Care
Shavers, V. L., Fagan, P., Jones, D., Klein, W. M. P., Boyington, J., Moten, C., & Rorie, E. (2012) · American Journal of Public Health · doi:10.2105/ajph.2012.300773 · Cited by 386
“In a notable exception, an audit study of 273 specialty practices in Cook County, Illinois, showed that 66% of persons posing as parents of a sick or injured child requiring urgent care who mentioned Medicaid-CHIP (Children Health Insurance Program) were denied an appointment compared with 11% of patients with private…”
BackgroundHealth Care Issues for Children and Adolescents in Foster Care and Kinship Care
Szilagyi, M. A., Rosen, D. S., Rubin, D. M., Zlotnik, S. R., Szilagyi, M. A., Harmon, D. A., Jaudes, P. K., Jones, V. F., Lee, P., Nalven, L. M., et al. (2015) · PEDIATRICS · doi:10.1542/peds.2015-2656 · Cited by 260
Perrin, J. M., Anderson, L. E., & Cleave, J. M. V. (2014) · Health Affairs · doi:10.1377/hlthaff.2014.0832 · Cited by 235
Hsiang, W. R., Lukasiewicz, A. M., Gentry, M., Kim, C.-Y., Leslie, M. P., Pelker, R. R., Forman, H. P., & Wiznia, D. H. (2019) · INQUIRY The Journal of Health Care Organization Provision and Financing · doi:10.1177/0046958019838118 · Cited by 222
“Table S1 in Supplemental Material summarizes the study characteristics of the 34 articles included in this review.(16-49) In total, the 34 studies represented 21,601 calls to provider Figure 1.”
Shared Decision Making and Choice for Elective Surgical Care
Boss, E. F., Mehta, N., Nagarajan, N., Links, A. R., Benke, J. R., Berger, Z. D., Espinel, A., Meier, J. D., & Lipstein, E. A. (2015) · Otolaryngology · doi:10.1177/0194599815620558 · Cited by 220
“As previously stated, the Patient Protection and Affordable Care Act includes a provision for a ‘‘program to facilitate SDM’’ (section 3506), including language describing patient decision aids and preference-sensitive care, although this authorized initiative has been yet unfunded.(28) One objective stated within the…”
BackgroundThe Affordable Care Act: implications for health-care equity
Gaffney, A. W., & McCormick, D. (2017) · The Lancet · doi:10.1016/s0140-6736(17)30786-9 · Cited by 180
The effect of socioeconomic status on access to primary care: an audit study
Olah, M. E., Gaisano, G., & Hwang, S. W. (2013) · Canadian Medical Association Journal · doi:10.1503/cmaj.121383 · Cited by 180
“Sorry, I’m Not Accepting New Patients”
Kugelmass, H. (2016) · Journal of Health and Social Behavior · doi:10.1177/0022146516647098 · Cited by 167
Trends in Pediatric Visits to the Emergency Department for Psychiatric Illnesses
Pittsenbarger, Z. E., & Mannix, R. (2013) · Academic Emergency Medicine · doi:10.1111/acem.12282 · Cited by 143
“Prior studies have shown payer-based differences to outpatient access to psychiatric services.(6,11,27) This may, in part, explain these increased visits as a downstream effect of challenges in accessing outpatient psychiatric care.”
Primary Care Access for New Patients on the Eve of Health Care Reform
Rhodes, K. V., Kenney, G. M., Friedman, A. B., et al. (2014) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2014.20 · Cited by 141
Self-citationIncreasing utilization of pediatric epilepsy surgery in the United States between 1997 and 2009
Pestana‐Knight, E., Schiltz, N. K., Bakaki, P. M., et al. (2015) · Epilepsia · doi:10.1111/epi.12912 · Cited by 140
Siegfried, E. C., Jaworski, J. C., & Hebert, A. A. (2013) · American Journal of Clinical Dermatology · doi:10.1007/s40257-013-0020-1 · Cited by 137
“Dermatology is among the most difficult subspecialty to gain access to for publically insured children [128].”
BackgroundAssociation of Pregnancy and Insurance Status With Treatment Access for Opioid Use Disorder
Patrick, S. W., Richards, M. R., Dupont, W. D., McNeer, E. A., Buntin, M. B., Martin, P., Davis, M. M., Davis, C. S., Hartmann, K. E., Leech, A. A., et al. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.13456 · Cited by 137
Reinhardt, U. E. (2011) · Health Affairs · doi:10.1377/hlthaff.2011.0813 · Cited by 134
Access to Subspecialty Care for Patients With Mobility Impairment
Lagu, T. C., Hannon, N. S., Rothberg, M. B., et al. (2013) · Annals of Internal Medicine · doi:10.7326/0003-4819-158-6-201303190-00003 · Cited by 134
“Inaccessible building 9 (4) 1 (3) 1 (3) 0 (0) 0 (0) 2 (6) 2 (6) 1 (3) 2 (6) Cannot transfer patient 47 (18) 4 (13) 13 (41) 8 (25) 6 (19) 7 (22) 6 (19) 3 (10) 0 (0) Would examine without transfer 75 (29) 8 (25) 0 (0) 0 (0) 0 (0) 0 (0) 21 (65) 18 (56) 28 (88)”
MethodTransition and Sickle Cell Disease
DeBaun, M. R., & Telfair, J. (2012) · PEDIATRICS · doi:10.1542/peds.2011-3049 · Cited by 133
Trends in Health Care Use Among Black and White Persons in the US, 1963-2019
Dickman, S., Gaffney, A. W., McGregor, A. J., Himmelstein, D. U., McCormick, D., Bor, D. H., & Woolhandler, S. J. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.17383 · Cited by 132
Kim, C.-Y., Wiznia, D. H., Hsiang, W. R., et al. (2015) · The Journal of Arthroplasty · doi:10.1016/j.arth.2015.03.015 · Cited by 108
“Previous studies have shown that patients with Medicaid have difficulty accessing orthopedic surgeons for a wide range of issues [8–12].”
ResultBerg, A. T., Loddenkemper, T., & Baca, C. B. (2013) · Epilepsia · doi:10.1111/epi.12479 · Cited by 106
Access to Office-Based Buprenorphine Treatment in Areas With High Rates of Opioid-Related Mortality
Beetham, T., Saloner, B. K., Wakeman, S. E., Gaye, M., & Barnett, M. L. (2019) · Annals of Internal Medicine · doi:10.7326/m18-3457 · Cited by 105
Quality of Health Insurance Coverage and Access to Care for Children in Low-Income Families
Kreider, A. R., French, B. C., Aysola, J., et al. (2015) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2015.3028 · Cited by 104
Disparities in access to specialized epilepsy care
Schiltz, N. K., Koroukian, S. M., Singer, M. E., Love, T. E., & Kaiboriboon, K. (2013) · Epilepsy Research · doi:10.1016/j.eplepsyres.2013.08.003 · Cited by 106
“Public insurance programs, articularly Medicaid, are designed to provide access to edical care for those who otherwise would be uninsured. et, people who carry this most basic form of health insurnce continue to face barriers to specialized care (Gold t al., 2006; Bisgaier and Rhodes, 2011).”
BackgroundEmerson, N. D., Morrell, H. E. R., & Neece, C. L. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2555-x · Cited by 111
“Access to outpatient specialty care has been shown to be limited for publicly insured children, likely due to specialists’ reluctance to accept public health insurance (Bisgaier and Rhodes 2011).”
BackgroundPediatric Dermatology: Past, Present, and Future
Prindaville, B., Antaya, R. J., & Siegfried, E. C. (2014) · Pediatric Dermatology · doi:10.1111/pde.12362 · Cited by 94
“A 2011 secret shopper surveyof follow-up appointment access from a pediatric emergency department in Cook County, Illinois, found a 66%denial rate for patients claimingMedicaid, comparedwith 11% for privately insured patients (33).”
BackgroundInfluentialSimulated Patient Studies: An Ethical Analysis
Rhodes, K. V., & Miller, F. G. (2012) · Milbank Quarterly · doi:10.1111/j.1468-0009.2012.00680.x · Cited by 89
“Bisgaier and Rhodes (2011) identified two dimensions of disparity in access to needed specialty care for children who are publicly insured (Medicaid-CHIP), compared with those who are privately insured.”
BackgroundSelf-citationLabrum, J. T., Paziuk, T. M., Rihn, T. C., et al. (2017) · Clinical Orthopaedics and Related Research · doi:10.1007/s11999-017-5263-3 · Cited by 87
Healthcare disparities in pediatric otolaryngology: A systematic review
Jabbour, J., Robey, T. C., & Cunningham, M. J. (2017) · The Laryngoscope · doi:10.1002/lary.26995 · Cited by 87
“highlighting the distinction between coverage and access.(33) By having women pose as mothers calling for appointments, once with private insurance and once with Medicaid (but each time with the same script and chief complaint), they demonstrated that government insurance did not translate to access because calls for…”
BackgroundInfluentialBoss, E. F., Benke, J. R., Tunkel, D. E., Ishman, S. L., Bridges, J. F. P., & Kim, J. M. (2014) · JAMA Otolaryngology–Head & Neck Surgery · doi:10.1001/jamaoto.2014.3085 · Cited by 85
Seeking health information online: does limited healthcare access matter?
Bhandari, N., Shi, Y., & Jung, K. (2014) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2013-002350 · Cited by 83
Cama, S., Malowney, M., Smith, A. J. B., Spottswood, M., Cheng, E., Ostrowsky, L., Rengifo, J., & Boyd, J. W. (2017) · International Journal of Health Services · doi:10.1177/0020731417707492 · Cited by 84
“25% in Ohio),(25,27) and other simulated patient studies have shown lower rates of initial appointment availability for Medicaid patients with several pediatric medical conditions.(25,29,30) One other study examining wait times for specialty appointments for children with Medicaid also found no significant difference…”
BackgroundMethodGraves, R., Andreyeva, E., Perrone, J., Shofer, F., Merchant, R., & Meisel, Z. F. (2019) · Journal of addiction medicine · doi:10.1097/adm.0000000000000492 · Cited by 65
Youths' Health-Related Social Problems: Concerns Often Overlooked During the Medical Visit
Hassan, A., Blood, E., Pikcilingis, A., Krull, E., McNickles, L., Marmon, G., Wylie, S. A., Woods, E. R., & Fleegler, E. W. (2013) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2013.02.024 · Cited by 75
Pediatric access to dermatologists: Medicaid versus private insurance
Chaudhry, S. B., Armbrecht, E. S., Shin, Y. A., Matula, S., Caffrey, C., Varade, R., Jones, L., & Siegfried, E. C. (2013) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2012.10.034 · Cited by 75
Children's Emergency Department Use for Asthma, 2001–2010
Nath, J. B., & Hsia, R. Y.-J. (2015) · Academic Pediatrics · doi:10.1016/j.acap.2014.10.011 · Cited by 74
Hesdorffer, D. C., Beck, V., Begley, C. E., Bishop, M. L., Cushner‐Weinstein, S., Holmes, G. L., Shafer, P. O., Sirven, J. I., & AUSTIN, J. K. (2013) · Epilepsia · doi:10.1111/epi.12056 · Cited by 70
“…disparities exist in access to epilepsy care for populations with low socioeconomic status, racial and ethnic minority populations, and uninsured populations (Bautista & Jain, 2011; Begley et al., 2009; Bisgaier & Rhodes, 2011; Elliott et al., 2009; Farhidvash et al., 2009; Halpern et al., 2011).”
Trends in Health Care Spending for Children in Medicaid With High Resource Use
Agrawal, R., Hall, M., Cohen, E., Goodman, D. M., Kuo, D. Z., Neff, J. M., O’Neill, M., Thomson, J. E., & Berry, J. G. (2016) · PEDIATRICS · doi:10.1542/peds.2016-0682 · Cited by 70
How Long Do Adolescents Wait for Psychiatry Appointments?
Steinman, K. J., Shoben, A. B., Dembe, A. E., & Kelleher, K. J. (2015) · Community Mental Health Journal · doi:10.1007/s10597-015-9897-x · Cited by 69
“For a variety of pediatric specialties in Cook County, Illinois, Bisgaier and Rhodes (2011) found that average wait time for Medicaid–CHIP enrollees was 22 days longer than for privately insured children.”
BackgroundOutpatient Office Wait Times And Quality Of Care For Medicaid Patients
Oostrom, T., Liran Einav, B., & Finkelstein, A. N. (2017) · Health Affairs · doi:10.1377/hlthaff.2016.1478 · Cited by 68
Racial and Ethnic Disparities in Outpatient Visit Rates Across 29 Specialties
Cai, C., Gaffney, A. W., McGregor, A. J., et al. (2021) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2021.3771 · Cited by 66
Socioeconomic status impacts outcomes following pediatric anterior cruciate ligament reconstruction
Patel, A. R., Sarkisova, N., Smith, R. A., et al. (2019) · Medicine · doi:10.1097/md.0000000000015361 · Cited by 65
Association of Simulated Patient Race/Ethnicity With Scheduling of Primary Care Appointments
Wisniewski, J., & Walker, B. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.20010 · Cited by 64
Disease Outcomes and Care Fragmentation Among Patients With Systemic Lupus Erythematosus
Walunas, T. L., Jackson, K., Chung, A. H., et al. (2016) · Arthritis Care & Research · doi:10.1002/acr.23161 · Cited by 62
“insurance that limits options for access to care (6,7).”
Grinspan, Z. M., Patel, A. D., Shellhaas, R. A., Berg, A. T., Axeen, E. T., Bolton, J. B., Clarke, D. F., Coryell, J. C., Gaillard, W. D., Goodkin, H. P., et al. (2020) · Epilepsia · doi:10.1111/epi.16733 · Cited by 63
Time to pediatric epilepsy surgery is related to disease severity and nonclinical factors
Baca, C. B., Vickrey, B. G., Vassar, S. D., et al. (2013) · Neurology · doi:10.1212/wnl.0b013e3182897082 · Cited by 58
Long-term impact of abusive head trauma in young children
Nuño, M., Ugiliweneza, B., Zepeda, V., et al. (2018) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2018.08.011 · Cited by 58
Unmet Need for Medical Care and Safety Net Accessibility among Birmingham’s Homeless
Kertesz, S. G., McNeil, W., Cash, J. J., Desmond, R. A., McGwin, G., Kelly, J. L., & Baggett, T. P. (2013) · Journal of Urban Health · doi:10.1007/s11524-013-9801-3 · Cited by 57
Temporal trends in pre-surgical evaluations and epilepsy surgery in the U.S. from 1998 to 2009
Schiltz, N. K., Koroukian, S. M., Lhatoo, S. D., & Kaiboriboon, K. (2012) · Epilepsy Research · doi:10.1016/j.eplepsyres.2012.07.016 · Cited by 57
Secret shopper studies: an unorthodox design that measures inequities in healthcare access
Rankin, K. A., Mosier-Mills, A., Hsiang, W. R., & Wiznia, D. H. (2022) · Archives of Public Health · doi:10.1186/s13690-022-00979-z · Cited by 57
“Other secret shopper studies have revealed insurance-related disparities in access to primary [8, 18, 26–28], follow-up [11], orthopedic [29], dermatologic [30], pediatric [31, 32], newborn [33], reproductive [5], and psychiatric [34] care, among others [35].”
BackgroundTipirneni, R., Rhodes, K. V., Hayward, R. A., Lichtenstein, R. L., Reamer, E. N., & Davis, M. M. (2015) · Health Affairs · doi:10.1377/hlthaff.2014.1425 · Cited by 57
Self-citationAn Overview of Health Disparities in Asthma.
Perez, M. F., & Coutinho, M. T. (2021) · Europe PMC (PubMed Central) · Cited by 56
Lyon, S. M., Douglas, I. S., & Cooke, C. R. (2014) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201402-072ps · Cited by 53
How long and how much? Wait times and costs for initial private child mental health appointments
Mulraney, M., Lee, C., Freed, G. L., SAWYER, M. G., Coghill, D., Sciberras, E., Efron, D., & Hiscock, H. (2020) · Journal of Paediatrics and Child Health · doi:10.1111/jpc.15253 · Cited by 52
Race, Relationships, and Trust in Providers among Black Patients with HIV/AIDS
Earl, T. R., Saha, S., Lombe, M., Korthuis, P. T., Sharp, V., Cohn, J. A., Moore, R. D., & Beach, M. C. (2013) · Social Work Research · doi:10.1093/swr/svt017 · Cited by 52
“Provision of services, as observed by Bisgaier and Rhodes (2011), may vary by patient characteristics (the “deserving” versus “undeserving”), whereby deserving patients (in possession of private health insurance) receive quality services compared to undeserving patients (those on public insurance).”
BackgroundInnovation and Best Practices in Health Care Scheduling
Brandenburg, L., Gabow, P. A., Health, D., et al. (2015) · NAM Perspectives · doi:10.31478/201502g · Cited by 52
“reported to be of key importance in the private setting where patients with Medicaid or no insurance coverage have longer wait times (Bisgaier and Rhodes, 2011).”
BackgroundLudomirsky, A. B., Schpero, W. L., Wallace, J., et al. (2022) · Health Affairs · doi:10.1377/hlthaff.2021.01747 · Cited by 52
Taking the Mystery out of “Mystery Shopper” Studies
Rhodes, K. V. (2011) · New England Journal of Medicine · doi:10.1056/nejmp1107779 · Cited by 51
Self-citationSocioeconomic Status Impacts Access to Orthopaedic Specialty Care
Ferati, S. R., Parisien, R. L., Joslin, P., et al. (2022) · JBJS Reviews · doi:10.2106/jbjs.rvw.21.00139 · Cited by 47
New Medicaid Enrollees In Oregon Report Health Care Successes And Challenges
ALLEN, H. L., Wright, B. J., & D, K. B. A. (2014) · Health Affairs · doi:10.1377/hlthaff.2013.1002 · Cited by 47
Health disparities among adults with voice problems in the United States
Hur, K., Zhou, S., Bertelsen, C., & Johns, M. M. E. (2017) · The Laryngoscope · doi:10.1002/lary.26947 · Cited by 47
“9% of otolaryngology providers contacted in that study accepted public insurance, which suggests an overburdening of a limited resource leading to longer wait times in the clinic and for appointments.(26) Disparities in access to outpatient otolaryngology specialty care for voice problems likely exist among those with…”
BackgroundInfluentialTrends in the use of puberty blockers among transgender children in the United States
Lopez, C. M., Solomon, D. G., Boulware, S. D., & Christison-Lagay, E. R. (2018) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem-2018-0048 · Cited by 45
“In most states, Medicaid has no platform for authorizing the use of histrelin implants for the management of a transgender-related diagnosis and a recent study demonstrated that overall, disparities exist in access to specialty pediatric services between privately insured and government insured patients [21].”
BackgroundPhysical Functioning in Boys with Hemophilia in the U.S.
Monahan, P. E., Baker, J., Riske, B., & Soucie, J. M. (2011) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2011.09.017 · Cited by 42
Malik, F. S., Hall, M., Mangione-Smith, R. M., Keren, R., Mahant, S., Shah, S. S., Srivastava, R., Wilson, K. M., & Tieder, J. S. (2016) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2015.12.015 · Cited by 44
Timing of Orchiopexy in the United States: A Quality-of-Care Indicator
Yiee, J. H., Saigal, C. S., Lai, J., et al. (2012) · Urology · doi:10.1016/j.urology.2012.08.008 · Cited by 42
“As federal efforts to improve population health gain momentum, the concept of “equality in quality” is salient in the environment of universal health care as quality should be preserved as health care coverage expands(21, 24, 25).”
BackgroundBaca, C. B., Pieters, H. C., Iwaki, T. J., Mathern, G. W., & Vickrey, B. G. (2015) · Epilepsia · doi:10.1111/epi.12988 · Cited by 41
Rhodes, K. V., Bisgaier, J., Lawson, C. C., Soglin, D. F., Krug, S., & Haitsma, M. V. (2013) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2012.10.030 · Cited by 41
Self-citationTreatment Patterns of Pediatric Patients with Atopic Dermatitis: A Claims Data Analysis.
Paller, A., Siegfried, E., Vekeman, F., Gadkari, A., Kaur, M., Mallya, U., Héroux, J., Miao, R., & Mina-Osorio, P. (2020) · Journal of American Academy of Dermatology · doi:10.1016/j.jaad.2019.07.105 · Cited by 38
Investigation of bias in an epilepsy machine learning algorithm trained on physician notes
Wissel, B. D., Greiner, H. M., Glauser, T. A., Mangano, F. T., Santel, D., Pestian, J. P., Szczesniak, R. D., & Dexheimer, J. W. (2019) · Epilepsia · doi:10.1111/epi.16320 · Cited by 42
“17 Once at a specialty center, these patients appeared to be better surgical candidates.”
BackgroundHooper, J., Shao, K., & Feng, H. (2022) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2021.12.061 · Cited by 39
Access to Care After Massachusetts’ Health Care Reform: A Safety Net Hospital Patient Survey
McCormick, D., Sayah, A. J., Lokko, H., et al. (2012) · Journal of General Internal Medicine · doi:10.1007/s11606-012-2173-7 · Cited by 39
National Estimates of and Risk Factors for Inpatient Revision Surgeries for Orofacial Clefts
Thompson, J. A., Heaton, P. C., Kelton, C. M. L., et al. (2016) · The Cleft Palate-Craniofacial Journal · doi:10.1597/15-206 · Cited by 39
“…programs covered revision surgery (Tables 2 and 3), hence it is possible that additional access barriers exist for low-income Medicaid families, a result consistent with both quantitative and qualitative findings from several recent studies (Bisgaier and Rhodes, 2011; Cassell et al., 2012).”
ResultHauptman, J. S., Dadour, A., Oh, T., et al. (2013) · Neurosurgery · doi:10.1227/01.neu.0000429849.99330.6e · Cited by 39
Celedon, J. C., Burchard, E. G., Schraufnagel, D. E., Castillo‐Salgado, C., Schenker, M. B., Balmes, J. R., Neptune, E., Cummings, K. J., Holguín, F., Riekert, K. A., et al. (2017) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201702-167ws · Cited by 39
Differences in Tonsillectomy Utilization by Race/Ethnicity, Type of Health Insurance, and Rurality
Cooper, J. N., Koppera, S., Boss, E. F., & Lind, M. (2020) · Academic Pediatrics · doi:10.1016/j.acap.2020.11.007 · Cited by 39
Effects of variations in access to care for children with atopic dermatitis
Siegfried, E., Paller, A., Mina-Osorio, P., Vekeman, F., Kaur, M., Mallya, U., Héroux, J., Miao, R., & Gadkari, A. (2020) · BMC Dermatology · doi:10.1186/s12895-020-00114-x · Cited by 30
“A number of factors, including unfavorable fee-for- service reimbursement, longer wait times for payments, and higher clinic nonattendance rates, contribute to the dearth of specialists accepting Medicaid patients [5, 8].”
BackgroundRacial and Ethnic Disparities in Primary Cleft Lip and Cleft Palate Repair
Mullen, M. C., Yan, F., Ford, M. E., et al. (2021) · The Cleft Palate-Craniofacial Journal · doi:10.1177/10556656211069828 · Cited by 38
“…repair include public insurance and its association with less timely care (Cassell et al., 2009; Zaluzec et al., 2019; Shaffer et al., 2020), a higher likelihood of not being seen by a specialist (Bisgaier and Rhodes, 2011), and a lower likelihood of having revision surgery (Thompson et al., 2017).”
BackgroundEmergency Care For Children In The United States
Chamberlain, J. M., Krug, S., & Shaw, K. N. (2013) · Health Affairs · doi:10.1377/hlthaff.2013.0871 · Cited by 37
Ranney, M. L., Pittman, S. K., DUNSIGER, S. I., Guthrie, K. M., Spirito, A., Boyer, E. W., & Cunningham, R. M. (2018) · Psychological Services · doi:10.1037/ser0000193 · Cited by 37
“These populations are traditionally difficult to engage in longitudinal preventive behavioral interventions (Bisgaier & Rhodes, 2011; DiCola, Gaydos, Druss, & Cummings, 2013; Owens et al., 2002), particularly when initiated in a nontraditional setting such as the ED (D’Onofrio et al., 2012).”
Academic Medical Centers and Equity in Specialty Care Access for Children
Polsky, D. (2011) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpediatrics.2011.1158 · Cited by 36
“This study leveraged audit study data from 273 specialty clinics, collected from January through May 2010, which determined that children with Medicaid-CHIP are more likely to be denied needed outpatient specialty services than children with private insurance.(12) The study took place in Cook County, Illinois, where M…”
BackgroundMethodInfluentialDodwell, E. R., Wright, J. G., Widmann, R. F., et al. (2015) · Journal of Pediatric Orthopaedics · doi:10.1097/bpo.0000000000000494 · Cited by 36
Predicting frequent emergency department visits among children with asthma using EHR data
Das, L. T., Abramson, E. L., Stone, A., Kondrich, J., Kern, L. M., & Grinspan, Z. M. (2017) · Pediatric Pulmonology · doi:10.1002/ppul.23735 · Cited by 36
“28 In New York City, geographic areas(Bronx inparticular)areassociatedwithhigherratesofenvironmentalexposure to household aeroallergens, which can exacerbate asthma.”
BackgroundFollow‐up and Time to Treatment in an Urban Cohort of Children with Sleep‐Disordered Breathing
Harris, V. C., Links, A. R., Kim, J. M., Walsh, J. M., Tunkel, D. E., & Boss, E. F. (2018) · Otolaryngology · doi:10.1177/0194599818772035 · Cited by 35
“Previous studies have shown that children with low socioeconomic status have longer wait times to outpatient subspecialty care and may have less access to otolaryngology surgical services in particular.(12-18,37) Children with low socioeconomic status often have public insurance, and reimbursement concerns may affect…”
Healthcare Disparities in Otolaryngology
Batool, S., Burks, C. A., & Bergmark, R. W. (2023) · Current Otorhinolaryngology Reports · doi:10.1007/s40136-023-00459-0 · Cited by 39
Accessing primary care: a simulated patient study
Campbell, J. L., Carter, M., Davey, A. F., et al. (2013) · British Journal of General Practice · doi:10.3399/bjgp13x664216 · Cited by 34
Preparation for Transition to Adult Care Among Medicaid-Insured Adolescents
Sawicki, G. S., Garvey, K. C., Toomey, S. L., Williams, K., Hargraves, J. L., James, T., Raphael, J. L., Giardino, A. P., Schuster, M. A., & Finkelstein, J. A. (2017) · PEDIATRICS · doi:10.1542/peds.2016-2768 · Cited by 33
Grinspan, Z. M., Patel, A. D., Hafeez, B., et al. (2017) · Epilepsia · doi:10.1111/epi.13948 · Cited by 33
“Male 1119 (53%) 171 (53%) 110 (59%) 54 (57%) ns Median distance from NCH, miles (IQR) 25 (9-57) 11 (7-33) 9 (5-24) 8 (5-16) < .”
InfluentialThe Use of a “Mystery Shopper” Methodology to Evaluate Children’s Access to Psychiatric Services
Steinman, K. J., Kelleher, K. J., Dembe, A. E., Wickizer, T. M., & Hemming, T. (2012) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-012-9275-1 · Cited by 32
“Bisgaier and Rhodes’s recent study, for example, included 40 randomly sampled clinics for each of the eight specialties they surveyed, although they focused on only one large metropolitan county.(13) Researchers should also anticipate the ethical considerations of using mystery shoppers.”
BackgroundType of Insurance and Use of Preventive Health Services Among Older Adults in Mexico
Rivera‐Hernandez, M., & Galárraga, O. (2015) · Journal of Aging and Health · doi:10.1177/0898264315569457 · Cited by 32
“…in utilization of medical services may also be due to insurance programs or plans that are structured to serve specific populations and features of the system where they provide health services (Bisgaier & Rhodes, 2011; Chang et al., 2014; Clark et al., 2014; Long, Coughlin, & King, 2005).”
BackgroundBarriers to Genetic Testing for Pediatric Medicaid Beneficiaries With Epilepsy
Kutscher, E. J., Joshi, S. M., Patel, A. D., Hafeez, B., & Grinspan, Z. M. (2017) · Pediatric Neurology · doi:10.1016/j.pediatrneurol.2017.04.014 · Cited by 32
Vermette, D., Shetgiri, R., Zuheiri, H. A., & Flores, G. (2014) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-014-0110-z · Cited by 31
“Sixty-six percent of children with public insurance are denied subspecialty appointments, versus 11 % with private insurance [44], and children with public insurance wait about 22 days longer for appointments [44].”
BackgroundEffects of a brief ED-based alcohol and violence intervention on depressive symptoms
Ranney, M. L., Goldstick, J. E., Eisman, A. B., Carter, P. M., Walton, M. A., & Cunningham, R. M. (2017) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2017.01.008 · Cited by 30
“(37) This finding may reflect disparities in access to healthcare among socio-economically disadvantaged youth.(9)”
BackgroundSurveillance of epilepsy and prevention of epilepsy and its sequelae
Hesdorffer, D. C., & Begley, C. E. (2013) · Current Opinion in Neurology · doi:10.1097/wco.0b013e32835ef2c7 · Cited by 30
Ndumele, C. D., Cohen, M. S., & Cleary, P. D. (2017) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2017.3766 · Cited by 29
“Reports have generally found that Medicaid enrollees have better access to specialists than the uninsured, but poorer access than commercially insured individuals.(6,8,9) Several communities have had success improving access to specialty care forMedicaid enrollees, but these efforts have been limited in scope, often r…”
BackgroundInsurance Status and the Care of Children in the Emergency Department
Mannix, R., Chiang, V., & Stack, A. M. (2012) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2012.03.013 · Cited by 28
Nguyen, J. T., Anandasivam, N. S., Cooperman, D. R., Pelker, R. R., & Wiznia, D. H. (2019) · Global Pediatric Health · doi:10.1177/2333794x19831299 · Cited by 28
Defining incident cases of epilepsy in administrative data
Bakaki, P. M., Koroukian, S. M., Jackson, L. W., et al. (2013) · Epilepsy Research · doi:10.1016/j.eplepsyres.2013.05.005 · Cited by 27
“…prevalence of chronic diseases in Medicaid population and low quality of care that they receive, which could lead to high mortality (Liu et al., 2006; LaPar et al., 2010; Bisgaier & Rhodes, 2011; Koroukian et al., 2012), requiring 7 or 8 years of continuous enrollment is probably too selective.”
BackgroundSocial and Structural Drivers of Health and Transition to Adult Care
Bailey, K., Avolio, J., Lo, L., Gajaria, A., Mooney, S., Greer, K., Martens, H., Tami, P., Pidduck, J., Cunningham, J., et al. (2023) · PEDIATRICS · doi:10.1542/peds.2023-062275 · Cited by 30
Mohan, A. V., Grant, J., Batalden, M., et al. (2013) · International Journal of Health Services · doi:10.2190/hs.43.2.h · Cited by 25
Malik, F. S., Yi‐Frazier, J. P., Taplin, C. E., Roth, C. L., Whitlock, K. B., Howard, W., & Pihoker, C. (2018) · The Science of Diabetes Self-Management and Care · doi:10.1177/0145721717750346 · Cited by 25
Metabolic Monitoring for Youths Initiating Use of Second-Generation Antipsychotics, 2003–2011
Connolly, J. G., Toomey, T., & Schneeweiss, M. C. (2015) · Psychiatric Services · doi:10.1176/appi.ps.201400222 · Cited by 29
Metadata
- Authors
- Bisgaier, J., & Rhodes, K. V.
- Affiliations
- University of Pennsylvania (US)
- ORCID
- Rhodes, Karin V.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2011-06-16
- Volume
- 364
- Issue
- 24
- Pages
- 2324-2333
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2106036024
- Semantic Scholar
- e71464628d0825673d4822789f1dfaa330229535
- Cited by
- 331
- References
- 40
- Citations by year
- 2026: 20 · 2025: 15 · 2024: 18 · 2023: 16 · 2022: 22 · 2021: 16 · 2020: 16 · 2019: 24 · 2018: 29 · 2017: 29 · 2016: 26 · 2015: 21 · 2014: 22 · 2013: 32 · 2012: 16
- FWCI
- 62.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- University Libraries (University of Maryland) (submittedVersion)
- Digital Repository at the University of Maryland (University of Maryland College Park)
- Funders
- University of Chicago
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Child and Adolescent Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Reforms
- Keywords
- access to specialist care, children, Medicaid, State Children's Health Insurance Program, public insurance, private insurance, insurance disparities, waiting time, outpatient care, health care reform
- MeSH terms
- Child, Child Health Services, Health Services Accessibility, Humans, Illinois, Insurance, Health, Medicaid, Specialization, United States, Insurance Coverage, Health Care Surveys, Clinical Audit, Patient Protection and Affordable Care Act
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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