A statewide assessment of tuberculin skin testing of preschool children enrolled in medicaid managed care.
OBJECTIVE
This study examined tuberculosis screening among preschool children enrolled in a statewide Medicaid managed care program.


METHODS
A random sample of 2,000 was selected from 19 to 35 month old children who were continuously enrolled in Rhode Island's Medicaid managed care program for 1 year. Sociodemographic data were obtained from computerized administrative databases. Medical record audits were performed to obtain the dates and results of tuberculosis tests.


RESULTS
Data from the medical record audits were available for 1,988 of the study children. For 1,215 of the study children (1,215/1,988 = 61%) a tuberculin skin test had been performed, but a reading was only documented for 736 children (60% of children who received a tuberculin skin test) and only one child tested positive (0.1%).


CONCLUSIONS
A majority of preschool children in this population in which the prevalence of risk factors for tuberculosis is likely to be relatively high did have a tuberculosis test performed. However, in many cases the tuberculin skin test was either not read or the results not documented. The low rate of positivity is consistent with current AAP guidelines for selective tuberculin skin testing.
Department of Community Health, Brown University, Providence, RI 02912, USA. Patrick_Vivier@Brown.edu
Patrick M
PM
Vivier
Christen
C
O'haire
Anthony J
AJ
Alario
Peter
P
Simon
Tricia
T
Leddy
Georges
G
Peter
D002662:Child Health Services / Q000592:standards / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003151:Community Health Centers / Q000592:standards; D004641:Emigration and Immigration; D019538:Health Care Surveys; D006279:Health Maintenance Organizations / Q000592:standards*; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000592:standards / Q000706:statistics & numerical data*; D008484:Medicaid / Q000458:organization & administration / Q000592:standards*; D016017:Odds Ratio; D010044:Outpatient Clinics, Hospital / Q000592:standards; D011203:Poverty; D011320:Primary Health Care / Q000458:organization & administration / Q000592:standards*; D011331:Private Practice / Q000592:standards; D017010:Reminder Systems; D012237:Rhode Island / Q000453:epidemiology; D012307:Risk Factors; D014374:Tuberculin Test / Q000592:standards / Q000706:statistics & numerical data*; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control