title: Transition to managed care impacts health care service utilization by children insured by Medicaid.
abstract: Purpose. To evaluate the impact of transition to managed care from fee for service on asthma service utilization among Maryland Medicaid insured children. Methods. Healthcare claims from 1997-2000 for children with asthma insured by Maryland Medicaid were extracted and analyzed. Results. Between 1997-2000, inhaled corticosteroid use increased as a proportion of all asthma medications. Outpatient asthma visits increased from 4.2% to 5.9% of all outpatient claims as both asthma-related hospitalizations and emergency department visits decreased. Conclusions. Restructuring of Maryland Medicaid for children from fee for service to managed care was associated with improvement in asthma-related healthcare utilization claims.
authors.affiliation: University of Maryland School of Medicine, Department of Pediatrics, Division of Pediatric Pulmonology/Allergy, Baltimore, Maryland 21201, USA. mbolling@peds.umaryland.edu
authors.forename: Mary Elizabeth
authors.initials: ME
authors.lastname: Bollinger
authors.forename: Sheila Weiss
authors.initials: SW
authors.lastname: Smith
authors.forename: Robert
authors.initials: R
authors.lastname: LoCasale
authors.forename: Carol
authors.initials: C
authors.lastname: Blaisdell
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy / Q000208:ethnology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D008396:Maryland; D008484:Medicaid / Q000706:statistics & numerical data; D014600:Utilization Review
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents