A synopsis of federal-state sponsored preventive child health

This synopsis presents data on the impact of services and evaluation issues for the nation's largest preventive child health program, the Early and Periodic Screening, Diagnosis and Treatment program (EPSDT). The information is drawn from a series of six EPSDT demonstration/evaluation (D/E) projects sponsored by the Health Care Financing Administration between 1972 and 1979. These projects were implemented in order to learn how to provide preventive services for children participating in the Medicaid program. The results of D/E activities are revised in a methodological framework as defined by principles of epidemiology and evaluation research. Consideration of the major threats to valid interpretation of the D/E findings shows self-selection to be the most serious methodological problem. Data pertaining to the history of use of preventive services, number of children found to have problems in screening, the treatment status and subjective seriousness of these problems, and the resolution of conditions referred to diagnosis and treatment are presented within the context of this methodological critique. The information thus assembled also provides the basis for further, more rigorous assessments of EPSDT program accountability.