The impact of managed care on children's access, satisfaction, use, and quality of care

Objective. To examine the impact of managed care on children's access, sati sfaction, use, and quality of care using nationally representative househol d survey data. Data Source. The 1996 Medical Expenditure Panel Survey (MEPS). Study Design. Bivariate and multivariate analyses are used to detect indepe ndent effects of managed care on access, satisfaction, utilization, and qua lity of pediatric health services. Data Collection/Extraction Methods. Data were obtained from rounds 1, 2, an d 3 of the 1996 MEPS. MEPS collects data on health care use, insurance, acc ess, and satisfaction, along with basic demographic and health status infor mation for a representative sample of the U. S, civilian, noninstitutionali zed population. Our sample consists of 5,995 children between the ages of 0 and 17. Findings. Among the 18 outcome indicators examined, the bivariate analysis revealed only three statistically significant differences between children enrolled in managed care and children in traditional health plans: children enrolled in managed care were more likely to receive physician services, m ore likely to have access to office-based care during evening or weekend ho urs, and less likely to report being very satisfied with overall quality of care. However, after controlling for confounding factors, none of these di fferences remained statistically significant. Conclusions. Our findings suggest that there are no statistically significa nt differences in self-reported outcomes for children enrolled in managed c are and traditional health plans. This conclusion is provisional, however, because of limitations in the data set.