Early and periodic screening, diagnosis, and treatment and infant health outcomes in Medicaid-insured infants in South Carolina.

Autor: Pittard WB 3rd; Department of Pediatrics, Division of Pediatric Epidemiology and Health Systems Research, Medical University of South Carolina, Charleston, SC 29425, USA. pittardw@musc.edu, Laditka JN, Laditka SB
Jazyk: angličtina
Zdroj: The Journal of pediatrics [J Pediatr] 2007 Oct; Vol. 151 (4), pp. 414-8. Date of Electronic Publication: 2007 Aug 23.
DOI: 10.1016/j.jpeds.2007.04.006
Abstrakt: Objectives: To test the hypothesis that infants experiencing the recommended number of early and periodic screening, diagnosis, and treatment (EPSDT) visits have better health outcomes than infants with fewer visits.
Study Design: Data represent all health encounters for Medicaid-insured infants of mothers aged at least 18 years in South Carolina, from 2000 to 2002, who were continuously enrolled in fee-for-service insurance (n = 36,662). We examined associations between having at least the recommended number of visits in the first year and health care use in the second year: sick infant doctor visits, emergency department (ED) visits, hospital admissions, and hospitalizations and ED visits for ambulatory care sensitive conditions.
Results: Infants with at least the recommended number of EPSDT visits had a higher adjusted rate of sick infant doctor visits (rate ratio, 1.49; 95% CI, 1.41-1.58), but a lower adjusted rate of ED visits for ambulatory care sensitive conditions (rate ratio, 0.94; 95% CI, 0.89-0.99). Having at least the recommended preventive visits did not affect rates of general ED visits or of hospitalizations.
Conclusions: Having at least the recommended number of EPSDT visits may shift some health provision from the ED to physicians' offices.
Databáze: MEDLINE
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