Shirley L. Porterfield

Medical home and out-of-pocket medical costs for children with special health care needs.

OBJECTIVE: We examined key factors that affect out-of-pocket medical expenditures per

Linking Models of Disability for Children with Developmental Disabilities

1000 of household income for children with special health care needs (CSHCN) with a broad range of conditions, controlling for insurance type and concentrating on the potentially moderating role of the medical home. METHODS: A Heckman selection model was used to estimate whether the medical home influenced out-of-pocket medical costs per

Building Financial Bridges to Economic Development and Community Integration

1000 of household income for children covered by either private or public health insurance. Data from the 2005–2006 National Survey of CSHCN (N = 31 808) were used. RESULTS: For families that incurred out-of-pocket medical costs for their CSHCN, these costs represented 2.2% to 3.9% of income. Both insurance type and the medical home had significant effects on out-of-pocket costs. Lower out-of-pocket medical costs per

Employment Change Among Married Parents of Children With Special Health Care Needs

1000 of income were incurred by children with public insurance and those receiving care coordination services. CONCLUSIONS: Families with CSHCN incur lower out-of-pocket medical costs when their children receive health care in a setting in which the care-coordination component of the medical home is in place.

Influencing choice of branded or generic statins by older adults in the USA

ABSTRACT Children with disabilities, their families, and the social workers who provide services are faced with navigating complex social and institutional environments in their quest for developmental, educational and daily living supports. Models of disabilities provide conceptual frameworks for understanding and action that can inform the decision-making process of parents and social workers. A new ecological model of disability, the systems model, is proposed that integrates the medical model, focused on individual deficits, the social model, focused on disabling social environments, and the transactional model, focused on person-environment interactions. Diagnostic, institutional, and practice implications of the new model are discussed.

The Ownership Society and Women: Exploring Female Householders’ Ability to Accumulate Assets

Abstract Research on asset accumulation among the population of people with disabilities is quite limited. Previous work indicates that people with disabilities have significantly fewer assets than people without disabilities. Research on asset development suggests that in general, individuals in lower income tiers are able to save and that holding assets has a positive relationship with general personal well being, economic security, and civic behavior and community involvement. Many individuals with disabilities are living in chronic poverty. For those who are unable to work, the accumulation of assets is difficult. Without significant savings, people with disabilities are unable to afford down payments on homes, capitalize small businesses, pay for advanced education, purchase assistive technology, or make accessibility-related architectural modifications to their homes. This paper recommends four significant areas to be considered in developing a research agenda on asset development for people with disabilities.

Employment change and the role of the medical home for married and single-mother families with children with special health care needs

Over one in five households with children has at least one child with a special health care need (CSHCN). Child health caregiving can bleed into paid work time. This research analyzes what factors influence work decisions (who reduces work and by how much) in married-couple families with CSHCN. This article uses data from the Medical Expenditure Panel Survey to examine the specifics of changes in parental work status and a comparison of family/work trade-offs made by parents in families with and without a CSHCN. Results indicate that mothers are more likely to experience negative work changes than fathers. Both mothers and fathers with CSHCN are more likely to report missing work than parents of children without special health care needs. Overall, when children receive treatment in a primary care practice that serves as a medical home, parents are less likely to experience negative employment changes.

The Influence of Health Insurance on Parent’s Reports of Children’s Unmet Mental Health Needs

This study examines whether information gained from face‐to‐face contact with health professionals has an influence on switching between branded and generic statins, a class of drugs primarily used by older adults.