Patterns of vision care among Medicaid-enrolled children.
OBJECTIVE
To describe patterns of vision care among Medicaid-enrolled children.


METHODS
We evaluated claims data over a 1-year period among children who were 18 years and younger, living in Michigan, and continuously enrolled in Medicaid but did not have a complex medical condition or were disabled. For this study, vision care comprised eye care services provided by optometrists or ophthalmologists and lens services, including dispensing and fitting of corrective lenses.


RESULTS
Children in rural counties had increased odds of receiving eye care (odds ratio [OR]: 1.24) or lens services (OR: 1.22) compared with those in urban counties. In urban counties, non-Hispanic white children had greater odds than Hispanic or nonwhite children to have eye care (OR: 1.37) and lens services (OR: 1.37). An increasing supply of eye care professionals per population within a county was associated with decreased vision care in urban counties and slightly increased eye care and no changes in lens services in rural counties. Urban children who received mostly fee-for-service Medicaid had greater odds of receiving vision care than those with longer periods of managed care. Rural children who received mostly fee-for-service Medicaid had greater odds of eye care but similar odds of lens services. Regardless of urban/rural status, girls had increased odds of receiving eye care (OR: 1.24 for urban, 1.20 for rural) and lens services (OR: 1.36 for urban, 1.24 for rural).


CONCLUSIONS
Patterns emerged that suggest underutilization or overutilization of vision care services. Such differences may have an impact on the development of children or waste limited health care resources.
Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan, USA. kempera@med.umich.edu
Alex R
AR
Kemper
Lisa M
LM
Cohn
Kevin J
KJ
Dombkowski
D002648:Child; D002662:Child Health Services / Q000191:economics / Q000706:statistics & numerical data*; D003261:Contact Lenses; D005139:Eyeglasses; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D008824:Michigan; D009885:Ophthalmology / Q000706:statistics & numerical data*; D009907:Optometry / Q000706:statistics & numerical data*; D012424:Rural Population; D014481:United States; D014505:Urban Population