Reliance on Acute Care Settings for Health Care Utilization: A Comparison of Adolescents With Younger Children.
Reliance on Acute Care Settings for Health Care Utilization: A Comparison of Adolescents With Younger Children.
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DOI：
10.1097/pec.0000000000001924
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发表时间：
2021-12-01
影响因子：
1.4
通讯作者：
Neuman MI
中科院分区：
文献类型：
--
作者：
Goyal MK;Richardson T;Masonbrink A;Reed JL;Alpern ER;Hall M;Neuman MI
Because a goal of the Affordable Care Act was to increase preventive care and reduce high cost care, the objective of this study was to evaluate current healthcare utilization and reliance on acute care settings among Medicaid-enrolled children. This was a retrospective cohort study of the 2015 Truven Marketscan Medicaid claims database among children 0-21 years old with at least 11 months of continuous enrollment. We calculated adjusted probabilities of healthcare utilization (any healthcare use and ≥ 1 health maintenance visit) and high acute care reliance (ratio of emergency department or urgent care visits to all health care visits > 0.33) by age and compared utilization between adolescents and younger children using multivariable logistic regression. Of the 5,182,540 Medicaid-enrolled children, 18.9% had no healthcare visits and 47.3% had ≥1 health maintenance visit in 2015. Both healthcare use and health maintenance visits decreased with increasing age (p<0.001). Compared to younger children (0-10 years old), adolescents were more likely to have no interaction with the healthcare system (aOR 2.20; 95% CI 2.19, 2.21) and less likely to have health maintenance visits (aOR 0.40; 0.39, 0.40). High acute care reliance was associated with increasing age, with adolescents having greater odds of high acute care reliance (aOR 1.08 [1.08, 1.09]). Medicaid-enrolled adolescents have low rates of healthcare utilization and have high reliance on acute care settings. Further investigation into adolescent-specific barriers to health maintenance care and drivers for acute care is warranted.
