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Preventive care for chronically ill children in medicaid managed care
Laura S Morris1, Anne M Schettine, Patrick J Roohan
1New York State Department of Health, Officeof Health Insurance Programs, Albany, USA. lxm26@health.state
The American Journal of Managed Care
|December 27, 2011
Summary
Children with chronic conditions in New York State Medicaid managed care receive preventive care at rates equal to or better than healthy children. This study highlights the value of analyzing quality data for specific patient groups.
Area of Science:
- Pediatric Health Services Research
- Health Outcomes and Quality of Care
- Chronic Disease Management in Children
Background:
- Preventive care is crucial for child development and long-term health.
- Understanding disparities in healthcare quality for children with chronic conditions is essential.
- Medicaid managed care serves a significant population of children, including those with chronic illnesses.
Purpose of the Study:
- To investigate the association between the quality of child preventive care and the presence of chronic conditions.
- To compare preventive care service utilization among children with varying health statuses within a Medicaid managed care population.
Main Methods:
- Retrospective cohort study of New York State children and adolescents in Medicaid managed care (2008).
- Health status categorized into healthy/acute, minor chronic, and significant chronic using a clinical algorithm on administrative data.
- Bivariate and logistic regression analyses compared quality of 10 preventive care services across health status groups.
Main Results:
- Approximately 25% of the cohort had minor or significant chronic conditions.
- Children with chronic conditions showed equal or higher probabilities of receiving recommended preventive care compared to healthy/acutely ill children.
- Risk ratios for increased preventive care service receipt in children with chronic conditions ranged from 1.03 to 1.17.
Conclusions:
- Preventive healthcare quality for children with chronic conditions in NYS Medicaid managed care is equivalent to or superior to that of healthy children.
- Combining quality measures with administrative health status data effectively identifies quality concerns in subpopulations.
- This approach aids in informing and driving state-level quality improvement initiatives for pediatric care.
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