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South Med J. 2013 Feb;106(2):173-9. doi: 10.1097/SMJ.0b013e3182826371.

Well-child care in infancy and healthcare services utilization from birth to 6 years by late preterm children receiving Medicaid benefits.

Author information

1
Department of Pediatrics, Division of Pediatric Epidemiology and Health Systems Research, Medical University of South Carolina, Charleston, USA. pittardw@musc.edu

Abstract

OBJECTIVES:

The hypotheses tested are that healthy late preterm (LP) children receiving Medicaid benefits use more healthcare services from birth to 6 years than do full-term (FT) children and that those who make the recommended number of early and periodic screening, diagnosis, and treatment (EPSDT) visits in the first 2 years require fewer services than those with fewer visits.

METHODS:

Data represent all of the health encounters for a 6-year birth cohort (1996-2001) of LP and FT children in South Carolina continuously enrolled in Medicaid birth to 6 years (N = 25,940). Associations were examined between making the recommended number of EPSDT visits in the first 2 years and sick-child office visits, emergency department (ED) visits, hospital admissions and hospitalizations, and ED visits for ambulatory care-sensitive conditions (ACSCs).

RESULTS:

LP children used more sick-child office visits and hospital admissions (P < 0.001) from birth to 6 years than FT children. LP children with at least the recommended number of EPSDT visits had a greater adjusted rate of sick-child office visits (rate ratio 1.62, confidence interval 1.30-2.02) and a lower adjusted rate of ACSC ED visits (rate ratio 0.79, confidence interval 0.65-0.96) than those making fewer visits. Making the recommended number of EPSDT visits did not affect rates of non-ACSC ED visits or of hospitalizations.

CONCLUSIONS:

LP children use more healthcare services in the first 6 years of life than do FT children, and those making the recommended number of EPSDT visits may shift some of their healthcare provision from the ED to providers' offices.

PMID:
23380754
DOI:
10.1097/SMJ.0b013e3182826371
[Indexed for MEDLINE]
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