Predictors of referral to the North Carolina Child Service Coordination Program among infants with orofacial clefts.
OBJECTIVE
North Carolina has several programs that identify high-risk women and children for needed services, including the Child Service Coordination Program (CSCP). This study determines CSCP referral rates among infants with orofacial clefts (OFCs) and predictors of CSCP referral. We hypothesized receiving Medicaid and maternity care coordination (MCC) services increases the likelihood of CSCP referral.


METHODS
For births between 1999 and 2002, data were matched from North Carolina Vital Statistics, Health Services Information System (MCC and CSCP data), and North Carolina Birth Defects Monitoring Program. Multivariate analysis was used to determine crude and adjusted odds ratios for sociodemographic variables to predict CSCP referral.


METHODS
A total of 644 mothers of live-born infants with OFCs in North Carolina were identified.


RESULTS
About 45% of infants with OFCs were referred to the CSCP. Infants of mothers who were at least 30 years of age and mothers who had more than a high school education were significantly less likely to be referred to the CSCP. Compared with infants with OFCs whose mothers did not receive Medicaid, mothers who received Medicaid were 1.9 times more likely to be referred to the CSCP, and mothers who received Medicaid and MCC services were 2.3 times more likely.


CONCLUSIONS
Receipt of Medicaid and MCC services and receipt of Medicaid alone were positively associated with CSCP referral. Future studies should examine the effects of the duration of MCC services and factors related to the timeliness of CSCP referral.
Cassell
Cynthia H
CH
North Carolina Birth Defects Monitoring Program, State Center for Health Statistics, Raleigh, NC 27699-1908, USA. cynthia.cassell@ncmail.net
Meyer
Robert E
RE
Farel
Anita M
AM
D000328:Adult; D002662:Child Health Services / Q000458:organization & administration*; D002971:Cleft Lip / Q000628:therapy*; D002972:Cleft Palate / Q000628:therapy*; D015331:Cohort Studies; D000013:Congenital Abnormalities; D019992:Databases as Topic; D004522:Educational Status; D005260:Female; D005544:Forecasting; D006801:Humans; D007223:Infant; D008423:Maternal Age; D008427:Maternal Health Services / Q000458:organization & administration; D008430:Maternal-Child Health Centers / Q000458:organization & administration*; D008484:Medicaid / Q000706:statistics & numerical data; D009657:North Carolina; D011159:Population Surveillance; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014481:United States; D014798:Vital Statistics