Changing patterns of conditions among children receiving supplemental security income disability benefits

Objective: To determine the relative growth of types of chronic health cond itions among children and adolescents receiving Supplemental Security Incom e (SSI) benefits before and after major SSI program changes, in: eluding ch anges in definitions of childhood disability and outreach to identify eligi ble children. Design: Retrospective analysis of Medicaid claims from California, Georgia, Michigan, and Tennessee. Participants: All children (aged less than or equal to 21 years) newly enro lled in SSI programs in these states from July 1989 (n=21 222) to June 1992 (n=38 789). Methods: Medicaid data indicate eligibility status and diagnoses for servic es rendered. For children newly enrolled before (time 1, July 1989 to June 1990), during (time 2, July 1990 to June 1991), and after (time 3, July 199 1 to June 1992) the program changes, we used claims for the first 6 months of enrollment to determine rates of chronic conditions in general and rates of asthma, attention-deficit/hyperactivity disorder (ADHD), and mental ret ardation specifically. We also followed up time I enrollees during the stud y period to determine the likelihood of a chronic condition claim at any ti me. Main Outcome Measure: Presence of claims for chronic conditions. Results: N ew SSI enrollees almost doubled during the study period. Increasing numbers of new enrollees had chronic condition claims in their first 6 months (fro m 29% to 36%); 58% of time 1 enrollees had such claims during any study mon th. Rates of chronic physical conditions other than asthma increased 14% (t ime 1 to time 3); asthma rates increased 73%. Rates of mental health condit ions other than mental retardation and ADHD increased 63%; rates of mental retardation decreased 29%, while rates of ADHD increased almost 3-fold. Con clusions: The number of children with chronic conditions receiving SSI bene fits experienced rapid growth from 1989 to 1992. Growth was particularly ma rked for children with diagnoses of asthma and ADHD.