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The extent and patterns of multiple chronic conditions in low-income children

Noreen M Clark1, Laurie Lachance2, M Beth Benedict3

  • 1University of Michigan, Ann Arbor, MI, USA Deceased.

Clinical Pediatrics
|March 25, 2015
PubMed

Insights

Multiple chronic conditions (MCC) are common in children with Medicaid, increasing their risk for urgent health care use. The more conditions a child has, the higher their likelihood of needing emergency care.

Area of Science:

  • Pediatric Health
  • Health Services Research
  • Chronic Disease Epidemiology

Background:

  • The prevalence and impact of multiple chronic conditions (MCC) in children are not well-understood.
  • Children receiving Medicaid assistance represent a vulnerable population for chronic disease burden.

Purpose of the Study:

  • To determine the prevalence and patterns of comorbidities in children enrolled in Medicaid.
  • To analyze the association between MCC and urgent healthcare utilization in this population.

Main Methods:

  • Analysis of 5 years of Medicaid claims data for 128,044 children with chronic conditions.
  • Logistic regression modeling to assess the relationship between comorbidities and significant urgent healthcare events.

Main Results:

  • 12% of children had claims for more than one chronic condition, with asthma and allergic rhinitis being the most frequent combination.
  • Urgent healthcare events occurred in 18% to 51% of children.
  • The risk of urgent healthcare events significantly increased with each additional condition, with those having four or more conditions showing 4.5 times the odds of an event compared to those with one condition (P < .0001).

Conclusions:

  • Multiple chronic conditions are prevalent among low-income children utilizing Medicaid.
  • MCC in children are strongly associated with an increased risk of urgent healthcare utilization.
Abstract

Keywords:
USasthmahealth care utilizationlow income childrenmedicaid claimsmultiple chronic conditionspatterns of comorbidities

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