Original Article

Well-Child Care in Infancy and Healthcare Services Utilization From Birth to 6 Years by Late Preterm Children Receiving Medicaid Benefits

Authors: William B. Pittard III MD, PhD

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.

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