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Perceived Barriers and Recommendations to Improve Well-Child Visits Among Medicaid Enrollees: An Explanatory
Insights
Many children with Medicaid miss well-child visits (WCVs), impacting preventive care. Barriers include cost, Medicaid complexity, and logistics, requiring community-informed solutions for equitable access and improved child health.
Area of Science:
- Public Health
- Health Services Research
- Pediatrics
Background:
- Well-child visits (WCVs) are crucial for preventive healthcare, early intervention, and immunizations in children.
- A significant number of children enrolled in Medicaid miss WCVs, creating disparities in healthcare access.
- Previous research often focused on either quantitative or qualitative data, lacking a comprehensive understanding of barriers.
Purpose of the Study:
- To investigate the multifaceted barriers to WCV attendance among Medicaid-enrolled families in North Dakota who missed all WCVs in 2021.
- To identify structural, economic, and cultural obstacles hindering WCV access.
- To develop community-informed recommendations for improving WCV attendance.
Main Methods:
- A mixed-methods, community-based approach was utilized.
- Analysis of administrative data for 64,364 children.
- Surveys administered to 1,294 families and focus groups with 40 participants.
Main Results:
- Identified significant barriers including cost concerns, lack of transparency in Medicaid processes, and logistical challenges.
- Structural, economic, and cultural factors were confirmed as major obstacles to WCV attendance.
- Community input highlighted the need for improved communication and accessibility.
Conclusions:
- Addressing identified barriers is essential for promoting equitable access to WCVs for Medicaid-enrolled children.
- Recommendations include enhancing Medicaid communication, providing culturally responsive care, and improving appointment accessibility.
- Overcoming these barriers can lead to better child health outcomes and reduced preventive care disparities.
Abstract:
Despite the critical role of well-child visits (WCVs) in preventive care, many Medicaid-enrolled children miss these appointments, leading to gaps in early intervention and immunization. Existing research has largely focused on either quantitative analyses of visit rates and predictors or qualitative insights into patient and provider experiences. This study employs a mixed-methods, community-based approach to examine barriers to WCV attendance among Medicaid-enrolled families in North Dakota who missed all WCVs in 2021. Through administrative data analysis (n=64,364), surveys (n=1,294), and focus groups (n=40), findings reveal structural, economic, and cultural obstacles, including cost concerns, lack of Medicaid transparency, and logistical challenges. Community-informed recommendations emphasize improved Medicaid communication, culturally responsive care, and enhanced appointment accessibility. Addressing these barriers could promote equitable access to WCVs, improve child health outcomes, and reduce disparities in preventive care for underserved populations.
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