title: Well-child care in infancy and healthcare services utilization from birth to 6 years by late preterm children receiving Medicaid benefits.
abstract: OBJECTIVE
  The hypotheses tested are that healthy late preterm (LP) children receiving Medicaid benefits use more healthcare services from birth to 6 years than do full-term (FT) children and that those who make the recommended number of early and periodic screening, diagnosis, and treatment (EPSDT) visits in the first 2 years require fewer services than those with fewer visits.
  
  
  METHODS
  Data represent all of the health encounters for a 6-year birth cohort (1996-2001) of LP and FT children in South Carolina continuously enrolled in Medicaid birth to 6 years (N = 25,940). Associations were examined between making the recommended number of EPSDT visits in the first 2 years and sick-child office visits, emergency department (ED) visits, hospital admissions and hospitalizations, and ED visits for ambulatory care-sensitive conditions (ACSCs).
  
  
  RESULTS
  LP children used more sick-child office visits and hospital admissions (P < 0.001) from birth to 6 years than FT children. LP children with at least the recommended number of EPSDT visits had a greater adjusted rate of sick-child office visits (rate ratio 1.62, confidence interval 1.30-2.02) and a lower adjusted rate of ACSC ED visits (rate ratio 0.79, confidence interval 0.65-0.96) than those making fewer visits. Making the recommended number of EPSDT visits did not affect rates of non-ACSC ED visits or of hospitalizations.
  
  
  CONCLUSIONS
  LP children use more healthcare services in the first 6 years of life than do FT children, and those making the recommended number of EPSDT visits may shift some of their healthcare provision from the ED to providers' offices.
authors: Department of Pediatrics, Division of Pediatric Epidemiology and Health Systems Research, Medical University of South Carolina, Charleston, USA. pittardw@musc.edu
authors: William B
authors: WB
authors: Pittard
mesh_terms: D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008484:Medicaid; D015999:Multivariate Analysis; D009819:Office Visits / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D014481:United States