title: The influence of having an assigned Medicaid primary care physician on utilization of otitis media-related services.
abstract: OBJECTIVE
  This study documents the influence of having an assigned Medicaid primary care physician (PCP) on the utilization of otitis media-related services.
  
  
  METHODS
  This is a retrospective study using the 1991 Colorado Medicaid administrative database that followed 28 844 children <13 years who had at least 1 visit for otitis media.
  
  
  RESULTS
  Children continuously enrolled in Medicaid throughout the entire year were >4 times (odds ratio: 4.2 and 4.89, respectively) as likely to always or sometimes have a PCP compared with children who were discontinuously enrolled. The likelihood of ever using the emergency department for an otitis media-related visit was increased by 26% and 50%, respectively, when a child sometimes or never had a PCP compared with always having a PCP. The likelihood of ever filling an antibiotic for otitis media was reduced by 23% and 34%, respectively, when a child sometimes or never had a PCP compared with always having a PCP. The likelihood of ever having otitis media-related surgery was not affected by PCP status, but young children, 13 to 18 months of age, had higher referral rates when they had an assigned PCP.
  
  
  CONCLUSIONS
  These findings suggest that having an assigned Medicaid PCP influences the utilization patterns of some otitis media-related medical services.
authors.affiliation: Department of Pediatrics, University of Colorado Health Sciences Center, Denver, Colorado, USA.
authors.forename: S
authors.initials: S
authors.lastname: Berman
authors.forename: J
authors.initials: J
authors.lastname: Bondy
authors.forename: D
authors.initials: D
authors.lastname: Lezotte
authors.forename: B
authors.initials: B
authors.lastname: Stone
authors.forename: P J
authors.initials: PJ
authors.lastname: Byrns
mesh_terms: D000233:Adenoidectomy / Q000706:statistics & numerical data; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003120:Colorado; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008484:Medicaid; D008876:Middle Ear Ventilation / Q000706:statistics & numerical data; D010033:Otitis Media / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D012017:Referral and Consultation; D012189:Retrospective Studies; D014481:United States