Impact of family health insurance and other environmental factors on universal hearing screen program effectiveness.
OBJECTIVE
The study objective was to evaluate the relationship among health insurance type, other demographic factors, and newborn hearing screen compliance and outcomes.


METHODS
The cohort consisted of 39,153 infants screened in Rhode Island between July 1, 1995 and June 30, 1998. Multivariate analyses were completed to evaluate relationships between health insurance type and completion of the in-hospital hearing screen and the rescreen, if indicated.


RESULTS
Successful newborn screen rates ranged from 98.1% to 99.8%. Infants with traditional Medicaid insurance were more likely to not be screened (p<0.0001) and to not return for a rescreen (p<0.0001). Infants in families with managed care Medicaid had screen compliance similar to infants with commercial health insurance. Multivariate analyses revealed that Medicaid insurance, no insurance, neonatal intensive care unit status, and out-of-state address predicted no initial screen (p<0.001) and no rescreen (p<0.0001).


CONCLUSIONS
In population-based health services, it is important that the effects of socioeconomic and demographic variables on outcomes be evaluated.
Vohr
Betty R
BR
Brown University School of Medicine and Women and Infants Hospital, Providence, RI 02905, USA.
Moore
Patricia E
PE
Tucker
Richard J
RJ
D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D019458:Insurance Coverage; D007348:Insurance, Health; D016015:Logistic Models; D008297:Male; D008329:Managed Care Programs; D008484:Medicaid; D017057:Medically Uninsured; D015997:Neonatal Screening / Q000191:economics / Q000706:statistics & numerical data*; D010349:Patient Compliance; D012237:Rhode Island; D014481:United States