Primary health care access, continuity, and cost among pediatric patients with obesity hypertension

Area of Science:

• Pediatric Health Services Research
• Health Disparities
• Health Economics

Background:

• Comorbid conditions and demographic factors influence healthcare access and costs.
• Obesity and primary hypertension are significant health concerns in children.
• Understanding service utilization patterns is crucial for equitable healthcare delivery.

Purpose of the Study:

• To investigate the association between comorbid medical conditions, race, gender, age, and healthcare service utilization and costs in children.
• To identify disparities in primary health care and associated costs for pediatric patients with obesity and hypertension.

Main Methods:

• Analysis of a statewide Medicaid database including medical and pharmacy claims from 1995-2004.
• Identification of a cohort of children (0-17 years) with and without obesity and primary hypertension.
• Comparison of service utilization (visits, procedures, facility use) and total costs between racial groups.

Main Results:

• Pediatric African American patients had more comorbid conditions but significantly fewer primary health care visits and lower total service utilization.
• African American children received fewer face-to-face visits, diagnostic services, emergency department visits, and inpatient services.
• Despite longer treatment durations, the total cost of care for African American pediatric patients was significantly lower.

Conclusions:

• Early and persistent disparities exist in healthcare service delivery to African American children with multiple medical needs.
• Racial disparities in healthcare access and utilization were evident in this cohort of children with obesity and hypertension.
• Further research is needed to address the systemic factors contributing to these healthcare disparities.