States' Scorecard Finds Big Differences in Kids' Health Care

Another key is having a "medical home" -- a regular source of care, Schor said. "Whereas 77 percent of children in New Hampshire had a medical home, in Mississippi, 34 percent had a medical home," he said. "We know that children who have a medical home have a better quality of care."

The scorecard took into account 13 indicators of children's health, including access, quality, costs, equity and the potential to lead a long and healthy life. While no state scored high on all categories, some regions surpassed others. For example, states in the Northeast and Upper Midwest often ranked higher in several areas, while the lowest rankings were in the South and Southwest, the report found.

Studies have shown that in states with high numbers of uninsured children, those children are less likely to get recommended health care, vaccines, dental care and regular checkups. These children are also at greater risk for developmental delays and infant mortality, Davis said.

But even in the highest-ranking states, quality of care falls short of goals, the report noted. In Massachusetts, the top-ranked state in quality, 75 percent of the children were seen by a doctor and a dentist in the past year, compared with only 46 percent of children in Idaho.

"One of the major efforts states can take to improve quality of care is to provide health insurance coverage to children, particularly low-income children," Davis said. "States that do a good job on that are among the states that are highest ranked on the various dimensions of quality of care. They are also the states that tend to do well on equity measures to help ensure that minority children and low-income children have better access to care and better quality of care".

One expert believes it's essential to increase funding for Medicaid and SCHIP to get more children covered by health insurance.

"We think this is a great report and it shows what we have been trying to show for a long time, which is how important Medicaid and SCHIP are to children's health," said Jenny Sullivan, a senior health policy analyst with the nonprofit, nonpartisan health care advocacy group Families USA. SCHIP legislation was enacted in 1997 to cover children in low-income families.

More information

To read the full report, visit the Commonwealth Fund.

SOURCES: May 27, 2008, teleconference with Karen Davis, president, and Edward L. Schor, M.D., vice president, Child Development and Preventive Care, The Commonwealth Fund, New York City; Jenny Sullivan, senior health policy analyst, Families USA, Washington, D.C.;U.S. Variations on Child Health System Performance: A State Scorecard