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Emergency department use and perceived delay in accessing illness care among children with Medicaid
Alison A Galbraith1, Jeanne Semura, Becky McAninch-Dake
1University of Washington, Seattle, Washington, USA. Alison_Galbraith@harvardpilgrim.org
Insights
Parents who perceive delays in accessing acute care for their children enrolled in Medicaid are more likely to use emergency departments (EDs). This highlights a critical access issue for pediatric healthcare.
Area of Science:
- Pediatric Health Services Research
- Health Services Accessibility
- Medicaid Managed Care
Background:
- Children enrolled in Medicaid face higher risks of emergency department (ED) utilization.
- Understanding factors contributing to ED use is crucial for improving healthcare access for this population.
Purpose of the Study:
- To investigate the association between perceived delays in accessing acute care and emergency department (ED) use among children covered by Medicaid.
- To identify if parental perception of timely care influences healthcare-seeking behaviors.
Main Methods:
- A cross-sectional study utilizing data from the 2000 Washington State Medicaid Consumer Assessment of Health Plans Survey.
- Multivariate logistic regression analysis was employed to assess the odds of ED use based on perceived delay in receiving illness care, controlling for demographic and health-related factors.
Main Results:
- The study included 5142 children, with 56.3% response rate.
- Parents reporting that their child did not always receive illness care as soon as wanted showed a significantly higher likelihood of ED use (adjusted odds ratio: 1.79).
- Perceived delay in care was a significant predictor of increased ED utilization.
Conclusions:
- Children in Medicaid managed care plans are more prone to utilize ED services when parents experience any perceived delay in obtaining timely illness care.
- Addressing parental concerns about delayed access to care may help reduce unnecessary ED visits.
Background:
Children covered by Medicaid are at increased risk of emergency department (ED) utilization.Objective.-To examine whether an association exists between ED use and perceived delay in accessing acute care.
Design And Setting:
Cross-sectional study. We used data from the Consumer Assessment of Health Plans Survey collected by Washington State Medicaid in 2000. We used multivariate logistic regression to determine the odds of any ED use, using a model that included whether the parent reported not always receiving illness care for the child as soon as wanted (perceived delay), age, gender, race/ethnicity, health status, presence of a special health care need, primary language, needing an interpreter, parental education, and having a regular provider.
Subjects:
Parents of a random sample of children from 9 Medicaid managed care plans were surveyed if their children were <15 years old and enrolled at least 6 months.
Main Outcome Measures:
Any ED use in the past 6 months.
Results:
The response rate was 56.3%, yielding 5142 subjects. Of children with illnesses in the previous 6 months, 69.1% of parents reported that their child always received care as soon as they wanted; 19.9%, 8.2%, and 2.8% reported usually, sometimes, and never, respectively. Not always (vs always) receiving illness care as soon as wanted was significantly associated with increased odds of any ED use (adjusted odds ratio: 1.79; 95% confidence interval: 1.35- 2.36).
Conclusion:
Children with managed care Medicaid are more likely to use the ED if parents perceive any delay in receiving illness care.
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