0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

Children in Foster Care in the State of Washington:  Health Care Utilization and Expenditures

John I. Takayama, MD, MPH; Abraham B. Bergman, MD; Frederick A. Connell, MD, MPH
JAMA. 1994;271(23):1850-1855. doi:10.1001/jama.1994.03510470054034.
Text Size: A A A
Published online

Objective.  —To determine and compare health care utilization and expenditures of children in foster care with those of other children and to identify and describe high-cost children in foster care.

Design.  —Analysis of the Medicaid program claims data in the state of Washington.

Population.  —A total of 1631 children in foster care and 5316 children in the Aid to Families With Dependent Children (AFDC) program in 1990. The children were ages 0 through 7 years and eligible for Medicaid continuously during the study year.

Main Outcome Measures.  —Health care utilization and expenditures classified by types of health service and health care provider; proportion of children with 1990 expenditures exceeding $10000 and most prominent diagnoses associated with their health care utilization.

Results.  —Mental health services were used by 25% of children in foster care compared with 3% of AFDC children (P<.001), and supportive services of visiting nurses and physical therapists were used by 13% of children in foster care and 1% of AFDC children (P<.001). Twice as many children in foster care than AFDC children used medical equipment or specialist services or were hospitalized (P<.001). Mean health care expenditures in 1990 were $3075 for children in foster care and $543 for AFDC children (P<.001). High-cost children included 8% of children in foster care and 0.4% of AFDC children. Among the high-cost children in foster care (n=106), 59% had mental disorders and 31% had congenital conditions.

Conclusions.  —Results suggest a higher prevalence and greater complexity of illnesses, particularly mental disorders, among children in foster care. Despite the high utilization and cost of mental health services, previous research suggests there may be underutilization of these services compared with need. Appropriate allocation of resources is essential if foster care agencies are to adequately meet the diverse and compelling needs of children in foster care.(JAMA. 1994;271:1850-1855)

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();