Table 1.
Health Care Expenditures and Utilization by Medicaid/CHIP and Child Special Health Care Needs (CSHCN) Status
| All Children | Not CSHCN | CSHCN | CSHCN: Severe | |||||
|---|---|---|---|---|---|---|---|---|
| Non-Medicaid | Medicaid/CHIP | Non-Medicaid | Medicaid/CHIP | Non-Medicaid | Medicaid/CHIP | Non-Medicaid | Medicaid/CHIP | |
| Demographics | ||||||||
| Age | 10 | 8 | 9 | 8 | 10 | 9 | 10 | 10 |
| Annual family income | 110,501 | 37,986 | 109,573 | 37,479 | 114,861 | 39,107 | 113,875 | 44,118 |
| Average annual health care spending per child (real 2019 dollars) | ||||||||
| Total | 2151 | 2115 | 1405 | 757 | 4518 | 5314 | 10,346 | 14,181 |
| Office | 669 | 468 | 467 | 231 | 1363 | 1054 | 3526 | 2789 |
| Emergency room | 118 | 98 | 95 | 73 | 185 | 159 | 264 | 241 |
| Hospital | 44 | 58 | 22 | 18 | 107 | 141 | 263 | 311 |
| Home Health | 27 | 188 | 4 | 12 | 110 | 628 | 363 | 3136 |
| Prescription drugs | 258 | 393 | 48 | 38 | 930 | 1280 | 2722 | 2554 |
| Share with non-zero utilization in a year | ||||||||
| Any health care | 87.3% | 85.0% | 85.2% | 81.4% | 96.6% | 95.4% | 97.3% | 98.3% |
| Office | 74.4% | 71.2% | 70.9% | 66.1% | 88.7% | 84.9% | 91.5% | 93.4% |
| Emergency room | 9.4% | 14.9% | 8.1% | 12.6% | 13.8% | 20.9% | 17.3% | 21.6% |
| Hospital | 1.7% | 2.9% | 1.2% | 1.6% | 2.7% | 5.2% | 5.4% | 9.4% |
| Home Health | 0.5% | 1.7% | 0.1% | 0.4% | 1.5% | 5.0% | 6.1% | 54.5% |
| Prescription drugs | 44.6% | 45.5% | 34.9% | 33.8% | 78.2% | 76.5% | 84.5% | 86.5% |
| Average out-of-pocket health care spending per child annually (real 2019 dollars) | ||||||||
| Total | 440.9 | 72.4 | 329.7 | 47.3 | 805.5 | 131.2 | 1463.1 | 280.7 |
| Office | 127.9 | 15.5 | 82.3 | 7.3 | 279.1 | 35.8 | 730.1 | 82.5 |
| Emergency room | 19.7 | 2.7 | 16.8 | 2.4 | 27.3 | 3.5 | 49.6 | 3.3 |
| Hospital | 15.0 | 3.2 | 10.3 | 1.7 | 20.6 | 4.7 | 28.6 | 7.2 |
| Home Health | 0.4 | 1.3 | 0.0 | 0.0 | 1.5 | 4.5 | 6.2 | 28.5 |
| Prescription drugs | 47.8 | 11.0 | 14.0 | 2.1 | 153.6 | 32.0 | 296.7 | 60.4 |
| Number children 0–17 | 52,047 | 58,238 | 36,787 | 39,145 | 10,092 | 13,779 | 718 | 1897 |
| Est. population (2008–18) | 535,414,213 | 325,898,220 | 382,913,949 | 220,990,786 | 118,379,878 | 89,641,163 | 8,765,576 | 13,591,263 |
CHIP indicates Child Health Insurance Program.
Notes: Author’s calculations based on Medical Expenditure Panel Survey, 2008 to 2018 which covers children 0 to 17. Insurance status is recorded as of December of the year before. Individual weights are applied to calculate population means. CSHCN are characterized as severe if they answer yes to 4 out of 5 qualifying questions. The questions pertain to the following: the need or use of medicines prescribed by a doctor; the need or use of more medical care, mental health, or education services than is usual for most children; being limited or prevented in doing things most children can do; the need or use of special therapy such as physical, occupational, or speech therapy; and the need or use of treatment or counseling for emotional, developmental, or behavioral problems.