News Release
Major Health Care Challenges Persist for D.C. Children Despite High Rates of Health Insurance Coverage
Oct 8, 2009
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This study is the first of its kind to comprehensively assess health and health care use among the more than 100,000 youth residing in Washington, D.C., considering both the children's health service delivery system and the communities where they live, which affect their health. The authors use survey, administrative, and focus group data to describe the health status of District children and their use of health services, with particular attention to changes over time in health status and health care use as well as differences by age, insurance status, and location within the city; assess environmental characteristics that may contribute to or ameliorate poor health outcomes among children; describe community resident and provider perspectives on child health service needs; and consider the implications of the evidence they synthesize for improving children's health in the District. The goal of the study is to lay a factual foundation for advocacy and policy decisions related to children's health in the District, as well as to help inform the allocation of community benefit resources by Children's National Medical Center, a children's hospital in the District.
Chapter One
Introduction
Part I
Setting the Context
Chapter Two
Infrastructure of the Health Care Delivery System for Children in the District
Chapter Three
Physical and Social Characteristics of District of Columbia Neighborhoods
Part II
Health and Health Care Use Among Children in the District
Chapter Four
Health Insurance, Sociodemographic Characteristics, and Health Status of District Children
Chapter Five
Use of Health Care Among District Children
Chapter Six
Use of Health Care Among District Children in Medicaid Managed Care and Fee-for-Service Medicaid
Chapter Seven
Use of Health Care Among District Children with Special Needs
Chapter Eight
Perspectives on Children's Health and Health Care Among District Parents, Adolescents, and Health Care Providers
Part III
Implications for Improving Child Health
Chapter Nine
Summary and Recommendations
Appendix A
Demographic, Geographic, and Health Plan Information
Appendix B
Analyses of the National Survey of Children's Health
Appendix C
Use of Health Care Services Through Children's National Medical Center
Appendix D
Review of Literature: Physical and Social Environment and Health
Appendix E
Methods: Developing Health Indices
Appendix F
Health Environment Maps
Appendix G
Analyses of Claims and Hospital Discharge Data
Appendix H
Focus Group Methodology and Demographic Characteristics
The research described in this report was supported by the Children's National Medical Center and conducted within RAND Health.
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