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S. Renée Gillespie 《Journal of Applied Communication Research》2013,41(2):97-116
This article examines how routine and ostensibly rational administrative and medical procedures required of asthmatic Medicaid patients to gain treatment under a managed care health delivery system, in fact, further disenfranchise them. 相似文献
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This paper introduces a research agenda to explore the intersection of e-government implementation and the key federal programs – Medicaid, the Supplemental Nutrition Assistance Program (SNAP, a.k.a. food stamps), (SSI), and Temporary Assistance to Needy Families (TANF, a.k.a. welfare) – that provide assistance to low-income citizens in the United States. To lay the groundwork for on-going research, this paper focuses on the implementing statutes that require different levels of automation for delivering these programs to the public. It discusses the programs in terms of their breadth, impacts to recipients, and the effects of automation as implemented for each. It identifies some of the consequences of automation, such as potentially faster service delivery, different approaches to information access, and issues of privacy. It then suggests some points to consider for policymakers and for future research to more deeply understand this unique and little-studied aspect of e-government implementation. By understanding the impacts of implementing statutes on the poor, policymakers can develop a deliberately inclusive strategy that leverages technology to support access to assistance in measurable models that can be implemented at the federal, state, and county levels. This can further democratize the government-to-citizen relationship and support greater accountability to taxpayers. 相似文献
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BackgroundExtensive research has documented the association between adverse childhood experiences (ACEs) and poor outcomes later in life, as well as the high prevalence of ACEs in the American population. Studies consistently find that over half of American adults have experienced at least one ACE. Despite this, research on the long-term impacts of ACEs is challenging due to the complex nature of adversity.ObjectiveOur study aimed to define underlying constructs of adversity, and explore how they changed throughout childhood, in a low-income population.Participants and SettingWe fielded a survey to Medicaid-enrolled adults in the Portland, OR metropolitan area.MethodsOur survey captured different experiences in childhood, including relationships and support, educational challenges, housing and employment stability, neighborhood environment, discrimination, abuse, neglect, and household dysfunction; questions were asked for 6–12 and 13–18 years of age. We then used factor analysis to identify underlying constructs of adversity in the two age ranges.ResultsWe identified two factors - Inadequate Emotional Support and Instability – in each age range. Inadequate Emotional Support remained consistent in both time periods while the Instability factor changed, expanding from household-centric experiences in childhood to a wider variety of experiences in adolescence. Additionally, a number of variables did not load on either factor in either age range.ConclusionsThese results underscore the importance of expanding how we think about instability specifically, and childhood adversity in general. 相似文献
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This article examines how routine and ostensibly rational administrative and medical procedures required of asthmatic Medicaid patients to gain treatment under a managed care health delivery system, in fact, further disenfranchise them. 相似文献
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Ramesh Raghavan Derek S. Brown Benjamin T. Allaire Lauren D. Garfield Raven E. Ross Lonnie R. Snowden 《Child abuse & neglect》2014
This study quantifies racial/ethnic differences in Medicaid expenditures on psychotropic drugs among a national sample of children with suspected maltreatment. We linked 4,445 child participants in the National Survey of Child and Adolescent Well-Being (NSCAW) – consisting of children investigated for suspected abuse and neglect – to their Medicaid claims obtained from 36 states. We used propensity score matching to construct a comparison group of children without known child welfare involvement, and estimated two-part generalized linear models to examine differences in annual psychotropic drug expenditures per child between children of different races/ethnicities. When compared to a matched sample of children, African American and Latino children incur $292 and $144 less expenditures on psychotropic drugs, respectively, than white children. Among NSCAW children alone, African American children display $614 less spending on psychotropic drugs when compared to white children. Racial/ethnic differences in expenditures on psychotropic drugs occur among all children on Medicaid, but the differences are especially pronounced among African American children in contact with the child welfare system. These findings demonstrate that policymakers will need to pay special attention to the needs of children of color as Medicaid expansions proceed nationwide. 相似文献
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