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Reliance on Acute Care Settings for Health Care Utilization: A Comparison of Adolescents With Younger Children.
Goyal, Monika K; Richardson, Troy; Masonbrink, Abbey; Reed, Jennifer L; Alpern, Elizabeth R; Hall, Matt; Neuman, Mark I.
Afiliación
  • Goyal MK; From the Department of Pediatrics, Children's National Health System, The George Washington University, Washington, DC.
  • Richardson T; Children's Hospital Association, Lenexa, Kansas.
  • Masonbrink A; Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City, Kansas City, Missouri.
  • Alpern ER; Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital, Northwestern University, Chicago, Illinois.
  • Hall M; Children's Hospital Association, Lenexa, Kansas.
  • Neuman MI; Division of Pediatric Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Pediatr Emerg Care ; 37(12): e1128-e1132, 2021 Dec 01.
Article en En | MEDLINE | ID: mdl-32776762
OBJECTIVE: Because a goal of the Affordable Care Act was to increase preventive care and reduce high-cost care, the objective of this study was to evaluate current health care use and reliance on acute care settings among Medicaid-enrolled children. METHODS: This was a retrospective cohort study of the 2015 Truven Marketscan Medicaid claims database among children 0 to 21 years old with at least 11 months of continuous enrollment. We calculated adjusted probabilities of health care use (any health care use and ≥1 health maintenance visit) and high acute care reliance (ratio of emergency department or urgent care visits to all health care visits >0.33) by age and compared use between adolescents and younger children using multivariable logistic regression. RESULTS: Of the 5,182,540 Medicaid-enrolled children, 18.9% had no health care visits and 47.3% had 1 or more health maintenance visit in 2015. Both health care use and health maintenance visits decreased with increasing age (P < 0.001). Compared with younger children (0-10 years old), adolescents were more likely to have no interaction with the health care system [adjusted odds ratio (aOR), 2.20; 95% confidence interval (CI), 2.19-2.21] and less likely to have health maintenance visits (aOR, 0.40; 0.39-0.40). High acute care reliance was associated with increasing age, with adolescents having greater odds of high acute care reliance (aOR, 1.08; 1.08-1.09). CONCLUSIONS: Medicaid-enrolled adolescents have low rates of health care use and have high reliance on acute care settings. Further investigation into adolescent-specific barriers to health maintenance care and drivers for acute care is warranted.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Medicaid / Patient Protection and Affordable Care Act Tipo de estudio: Observational_studies / Risk_factors_studies Aspecto: Implementation_research Límite: Adolescent / Adult / Child / Child, preschool / Humans / Infant / Newborn País/Región como asunto: America do norte Idioma: En Revista: Pediatr Emerg Care Asunto de la revista: MEDICINA DE EMERGENCIA / PEDIATRIA Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Medicaid / Patient Protection and Affordable Care Act Tipo de estudio: Observational_studies / Risk_factors_studies Aspecto: Implementation_research Límite: Adolescent / Adult / Child / Child, preschool / Humans / Infant / Newborn País/Región como asunto: America do norte Idioma: En Revista: Pediatr Emerg Care Asunto de la revista: MEDICINA DE EMERGENCIA / PEDIATRIA Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos