Well-Child Visits of Medicaid-Insured Children with Medical Complexity

Title

Well-Child Visits of Medicaid-Insured Children with Medical Complexity

Creator

Shumskiy I; Richardson T; Brar S; Hall M; Cox J; Crofton C; Peltz A; Samuels-Kalow M; Alpern ER; Neuman Mark I; Berry Jay G

Publisher

Journal of Pediatrics

Date

2018

Description

OBJECTIVE: Well-child visits (WCVs) help optimize children's health. We measured annual WCVs for children with medical complexity (CMC) and correlated WCVs with hospitalizations. STUDY DESIGN: This was a retrospective analysis of 93 121 CMC aged 1-18 years continuously enrolled in 10 state Medicaid programs in the Truven MarketScan Database between 2010 and 2014. CMC had a complex chronic condition or 3 or more chronic conditions of any complexity identified from International Classification of Diseases, Ninth Revision codes, and the use of 1 or more chronic medications. We measured the number of years with 1 or more WCVs. The χ2 test and logistic regression were used to assess the relationships of WCV-years with the children's characteristics and hospitalization. RESULTS: Over 5 years, 13.4% of CMC had 0 WCVs; 17.3% had WCVs in 1 year, 40.8% had WCVs in 2-3 years, and 28.5% had WCVs in 4-5 years. Fewer children received WCVs in 4-5 years when enrolled in Medicaid fee-for-service compared with managed care (20.9% vs 31.5%; P < .001) and when enrolled due to a disability compared with another reason (18.2% vs 32.2%; P < .001). The percentage of CMC hospitalized decreased as the number of years receiving WCV increased (21.5% at 0 years vs 16.9% at 5 years; P < .001). The adjusted odds of hospitalization were higher in CMC with WCVs in 0-4 years compared with CMC with WCVs in all 5 years (OR range across years, 1.1 [95% CI, 1.0-1.2] to 1.3 [95% CI, 1.3-1.4]). CONCLUSIONS: Most Medicaid-insured CMC do not receive annual WCVs consistently over time. Children with fewer annual WCVs have a higher likelihood of hospitalization. Further investigation is needed to improve the use of WCVs in CMC.

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Citation List Month

September 2018 List

Collection

Citation

Shumskiy I; Richardson T; Brar S; Hall M; Cox J; Crofton C; Peltz A; Samuels-Kalow M; Alpern ER; Neuman Mark I; Berry Jay G, “Well-Child Visits of Medicaid-Insured Children with Medical Complexity,” Pediatric Palliative Care Library, accessed October 7, 2022, https://pedpalascnetlibrary.omeka.net/items/show/15199.

Social Bookmarking