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Impact of family health insurance and other environmental factors on universal hearing screen program effectiveness
Betty R Vohr1, Patricia E Moore, Richard J Tucker
1Brown University School of Medicine and Women and Infants Hospital, Providence, RI 02905, USA.
Insights
Newborn hearing screening compliance is impacted by health insurance type. Traditional Medicaid patients were less likely to complete initial and follow-up screenings compared to commercially insured infants.
Area of Science:
- Health Services Research
- Public Health
- Neonatal Care
Background:
- Newborn hearing screening is crucial for early detection of hearing loss.
- Understanding factors influencing screening compliance is vital for public health initiatives.
Purpose of the Study:
- To examine the association between health insurance type and newborn hearing screening compliance.
- To identify demographic factors affecting hearing screen outcomes.
Main Methods:
- Analysis of a cohort of 39,153 infants screened in Rhode Island (1995-1998).
- Multivariate analyses to assess relationships between insurance type and screening completion.
- Evaluation of in-hospital screening and rescreen compliance.
Main Results:
- Overall newborn screening rates were high (98.1%-99.8%).
- Infants with traditional Medicaid insurance showed significantly lower compliance for initial and follow-up screenings.
- Managed care Medicaid and commercial insurance had similar compliance rates.
- Medicaid, lack of insurance, NICU status, and out-of-state address predicted non-compliance.
Conclusions:
- Socioeconomic and demographic factors, particularly insurance type, significantly influence newborn hearing screening outcomes.
- Health services must consider these variables to improve population-based screening effectiveness.
Objective:
The study objective was to evaluate the relationship among health insurance type, other demographic factors, and newborn hearing screen compliance and outcomes.
Study Design:
The cohort consisted of 39,153 infants screened in Rhode Island between July 1, 1995 and June 30, 1998. Multivariate analyses were completed to evaluate relationships between health insurance type and completion of the in-hospital hearing screen and the rescreen, if indicated.
Results:
Successful newborn screen rates ranged from 98.1% to 99.8%. Infants with traditional Medicaid insurance were more likely to not be screened (p<0.0001) and to not return for a rescreen (p<0.0001). Infants in families with managed care Medicaid had screen compliance similar to infants with commercial health insurance. Multivariate analyses revealed that Medicaid insurance, no insurance, neonatal intensive care unit status, and out-of-state address predicted no initial screen (p<0.001) and no rescreen (p<0.0001).
Conclusion:
In population-based health services, it is important that the effects of socioeconomic and demographic variables on outcomes be evaluated.
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