Affiliations: Department of Physical Medicine and Rehabilitation,
University of Pittsburgh, Pittsburgh, PA, USA | Department of Social and Behavioral Sciences,
University of California San Francisco, San Francisco, CA, USA
Note: [] Corresponding author: Amy Houtrow, MD, Department of Physical
Medicine and Rehabilitation, University of Pittsburgh, 4401 Penn Ave, Suite
1200, Pittsburgh, PA, USA. Tel.: +1 412 692 5097; Fax: +1 412 692 6462; E-mail: houtrow@upmc.edu
Abstract: Introduction: Individuals with cerebral palsy (CP) may require
personal assistance services for optimal functioning. The primary goal of this
project is to determine if differences in health services exist between
individuals with CP with family versus non-family member paid personal
assistance providers. The secondary goal is to describe the population of
children and non-elderly adults with CP receiving In-Home Supportive Services
(IHSS) and determine their health care costs compared to other IHSS recipients. Methods: Administrative data from the California Departments of Health
and Human Services, Social Services and Developmental Services were linked and
de-identified to provide information about individuals receiving IHSS in
California in 2005. Recipients with CP were characterized and compared by age.
Then to determine the factors associated with hospital use and emergency room
(ER) use for IHSS recipients with CP adjusted odds were calculated. Monthly
expenditures were calculated from claims data. Results: 2.3% of all
IHSS recipients in 2005 had CP of which 46% were children. 59% of
recipients with CP have a parent as their paid provider. The presence of other
medical diagnoses was the only factor associated with increased adjusted odds
of hospital and ER use for both child-aged and non-elderly adult recipients
with CP. Functional limitations and provider type were not associated with
increased odds of health care utilization. Monthly health care expenditures for
recipients with CP were ∼ $1000 higher than for other IHSS recipients. Conclusions: Having a parent as the IHSS provider was not associated with
difference in health service utilization. This finding supports the policy of
allowing parents to be paid providers.
Keywords: Cerebral palsy, personal assistance services, Medicaid, health care utilization, expenditures
