Infant health outcomes associated with voluntary health care model change in a choice-based Medicaid system.
BACKGROUND
Medicaid health plan enrollment changes may be a barrier to optimal care and may increase costs.


METHODS
Data represented 45,768 infants enrolled in Medicaid in South Carolina, 2000-2002. We examined associations between health plan changes and preventive health care, sick infant doctor visits, emergency department (ED) visits, and hospitalizations.


RESULTS
In adjusted results, compared to infants without plan changes, those with changes averaged 40% fewer preventive health visits (P <0.001), over 35% fewer sick infant doctor visits (P < 0.01), 77% more hospitalizations in year one (P <0.001), and 43% more potentially preventable hospitalizations in year one (P <0.01).


CONCLUSIONS
Infants on Medicaid with a health plan change have less preventive health care, are much less likely to be treated for illness in physicians' offices, and have substantially more costly medical care. These results may be due to unmeasured maternal or family characteristics, or care continuity loss. Plan changes may indicate higher infant health risks.
Pittard
William B
WB
Department of Pediatrics, Division of Pediatric Epidemiology and Health Systems Research, Medical University of South Carolina, Charleston, SC 29425, USA. pittardw@musc.edu
Laditka
James N
JN
Laditka
Sarah B
SB
D016022:Case-Control Studies; D002755:Choice Behavior; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D018588:Fee-for-Service Plans; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013022:South Carolina; D014481:United States