Emergency Department Reliance Among Rural Children in Medicaid in New York State
Purpose: This study examines variation in emergency department reliance (EDR) between rural and metro pediatric Medicaid patients in New York State for noninjury, nonpoisoning primary diagnoses and seeks to determine the relationship between receipt of preventive care and the likelihood of EDR. Meth...
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Published in | The Journal of rural health Vol. 28; no. 2; pp. 152 - 161 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
Malden, USA
Blackwell Publishing Inc
01.03.2012
Wiley-Blackwell Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
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Summary: | Purpose: This study examines variation in emergency department reliance (EDR) between rural and metro pediatric Medicaid patients in New York State for noninjury, nonpoisoning primary diagnoses and seeks to determine the relationship between receipt of preventive care and the likelihood of EDR.
Methods: Rural/urban designations were based on Urban Influence Codes established by the United States Department of Agriculture (USDA). Healthcare Effectiveness Data and Information Set (HEDIS®) well‐visit measures were calculated using 2008 Medicaid claims and encounter data. Well‐child numerator status and location of residence variables were then entered as independent variables in multivariate logistic regression models. Models controlled for the effects of Medicaid financing system (fee‐for‐service vs managed care), Medicaid aid type, race/ethnicity, gender, and 2008 clinical risk group category.
Findings: The likelihood of EDR was higher in all age categories for rural compared to metro residing Medicaid children in New York State. Meeting HEDIS well‐child criteria was protective against emergency department (ED) reliance in the adolescence age group (OR = 0.84).
Conclusion: ED reliance is associated with rural residence. Increased access to primary and specialty care in rural settings could help reduce EDR, particularly among rural adolescents. |
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Bibliography: | ArticleID:JRH377 ark:/67375/WNG-X6Q8FC4G-F istex:E7D68F0149C0B370E6A1400F28B24527C714BFD2 No outside funding was used to support this research. For further information, contact: Victoria L. Wagner, MS, Office of Health Insurance Programs, NYS Department of Health, Empire State Plaza, Room 1938, Albany, NY 12237; e‐mail lw03@health.state.ny.us . ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2 |
ISSN: | 0890-765X 1748-0361 |
DOI: | 10.1111/j.1748-0361.2011.00377.x |