The impact of the Iowa S-SCHIP program on access, health status, and the family environment

Ambul Pediatr. Sep-Oct 2003;3(5):263-9. doi: 10.1367/1539-4409(2003)003<0263:tiotis>;2.


Objectives: To determine the effect of the Iowa Separate State Child Health Insurance Program (S-SCHIP) on need for services, utilization and access to care, child health status, and the family environment.

Methodology: A longitudinal pretest-posttest panel survey was used to evaluate differences in children's access to health care, health status, and family environment at the beginning of the program and after 1 year. Written surveys with telephone follow-up calls were used to collect the data. Pre- and postquestionnaire results for 463 children were matched and compared using the McNemar test for correlated proportions and the Wilcoxon signed rank test. Approximately 71% of families responded to both surveys.

Principal findings: Similar rates of perceived need for each of 6 service areas were found after being in the program for a year as before. Unmet need was significantly reduced among those needing services: medical care (27% before, 6% after), specialty care (40% before, 13% after), dental care (30% before, 10% after), vision care (46% before, 12% after), behavioral and emotional care (42% before, 18% after), and prescription medications (21% before, 13% after). Overall health status was rated significantly better (ie, excellent: 37% before, 42% after). Ninety-five percent of families reported a reduction in family stress, and there was significantly less worry about the ability to pay for their child's health care (92% before, 57% after). The activities of fewer children were limited because of potential health care costs.

Conclusions: The Iowa S-SCHIP program improved access to care and the family environment for children enrolled during the first year without a change in perceived need for services.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child Health Services*
  • Child, Preschool
  • Delivery of Health Care*
  • Dental Care
  • Female
  • Health Status*
  • Humans
  • Infant
  • Insurance, Health
  • Iowa
  • Longitudinal Studies
  • Male
  • Medicaid*
  • Medicine
  • Primary Health Care
  • Quality of Health Care*
  • Specialization
  • State Medicine*