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Well-Child Visits of Medicaid-Insured Children with Medical Complexity

Igor Shumskiy1, Troy Richardson2, Sumeet Brar3

  • 1Boston Combined Residency Program in Pediatrics, Harvard Medical School, Boston University School of Medicine, Boston, MA.

The Journal of Pediatrics
|May 13, 2018
PubMed

Insights

Children with medical complexity (CMC) often miss annual well-child visits (WCVs). Consistent WCVs are linked to fewer hospitalizations, highlighting the need to improve access for these vulnerable children.

Area of Science:

  • Pediatric Health Services Research
  • Healthcare Access and Utilization

Background:

  • Well-child visits (WCVs) are crucial for optimizing child health outcomes.
  • Children with medical complexity (CMC) represent a vulnerable population with unique healthcare needs.
  • Understanding WCV utilization patterns in CMC is essential for improving care coordination and health outcomes.

Purpose of the Study:

  • To measure annual WCV utilization among children with medical complexity (CMC).
  • To correlate WCV frequency with hospitalization rates in CMC.
  • To identify factors influencing WCV adherence in this population.

Main Methods:

  • Retrospective analysis of 93,121 CMC aged 1-18 years enrolled in state Medicaid programs (2010-2014).
  • CMC defined by complex chronic conditions or multiple chronic conditions and medication use.
  • Statistical analysis (chi-squared test, logistic regression) to assess WCV-years and hospitalization relationships.

Main Results:

  • Over 5 years, 13.4% of CMC had no WCVs; 28.5% had WCVs in 4-5 years.
  • Lower WCV rates observed in fee-for-service Medicaid and for children enrolled due to disability.
  • Increased WCV frequency correlated with decreased hospitalization rates (21.5% at 0 years vs. 16.9% at 5 years).

Conclusions:

  • A significant proportion of Medicaid-insured CMC lack consistent annual WCVs.
  • Fewer WCVs are associated with a higher likelihood of hospitalization in CMC.
  • Interventions are needed to enhance WCV utilization among children with medical complexity.
Abstract

Keywords:
children with medical complexityhospitalizationprimary carewell child visits

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