Journal article
An explanatory model of factors related to well baby visits by age three years for Medicaid-enrolled infants: a retrospective cohort study
BMC Pediatrics, Vol.13, 158
10/05/2013
DOI: 10.1186/1471-2431-13-158
PMCID: PMC3852856
PMID: 24093970
Abstract
<p>Background: Well baby visits (WBVs) are a cornerstone of early childhood health, but few studies have examined the correlates of WBVs for socioeconomically vulnerable infants. The study objective was to identify factors related to the number of WBVs received by Medicaid-enrolled infants in the first three years of life and to present a preliminary explanatory model. Methods: We analyzed Iowa Medicaid claims files and birth certificate data for infants born in calendar year 2000 (N = 6,085). The outcome measure was the number of well baby visits (WBVs) received by Medicaid-enrolled infants between age 1 and 41 months (range: 0 to 10). An ecological health model and existing literature were used to evaluate 12 observed factors as potential WBV correlates. We ran multiple variable linear regression models with robust standard errors (α = 0.05). Results: There were a number of infant, maternal, and health system factors associated with the number of WBVs received by Medicaid-enrolled infants. Infants whose mothers had a greater number of prenatal healthcare visits (ß = 0.24 to 0.28; P = .001) or were married (ß = 0.20; P = .002) received more WBVs. Having a chronic health condition (ß = 0.51; P < .0001) and enrollment in a case management program (ß = 0.48; P < .0001) were also positively associated with WBVs. Eligibility for Medicaid through the Supplemental Security Income Program (ß = −0.70; P = .001), increased maternal age (ß = −0.27 to −0.35; P = .004), higher levels of maternal education (ß = −0.18; P = .005), maternal smoking (ß = −0.13; P = .018), and enrollment in a health maintenance organization plan (ß = −1.15; P < .0001) were negatively associated with WBVs. There was a significant interaction between enrollment in a health maintenance organization plan and enrollment in a Medicaid case management program (P = .015). Maternal race, maternal alcohol use during pregnancy, and rurality were not significantly related to the number of WBVs. Conclusions: Multiple infant, maternal, and health system variables were related to the number of WBVs received by Medicaid-enrolled infants. Additional research is needed to develop strategies to optimize access to WBVs for Medicaid-enrolled infants at risk for poor use of preventive medical care services.</p>
Details
- Title: Subtitle
- An explanatory model of factors related to well baby visits by age three years for Medicaid-enrolled infants: a retrospective cohort study
- Creators
- Donald L. Chi - University of WashingtonElizabeth T. Momany - University of IowaMichael P. Jones - University of IowaRaymond A. Kuthy - University of IowaNatoshia M. Askelson - University of IowaGeorge L. Wehby - University of IowaPeter C. Damiano - University of Iowa
- Resource Type
- Journal article
- Publication Details
- BMC Pediatrics, Vol.13, 158
- DOI
- 10.1186/1471-2431-13-158
- PMID
- 24093970
- PMCID
- PMC3852856
- NLM abbreviation
- BMC Pediatr
- ISSN
- 1471-2431
- Copyright
- © 2013 Chi et al.
- Grant note
- This study was supported by the U.S. National Institute of Dental and Craniofacial Research (Grants RC1DE020303 and K08DE020856), the U.S. National Institute of Minority Health and Health Disparities (Grant L60MD003921), and the William T. Grant Foundation Scholars Program. We thank the Iowa Department of Human Services for access to Medicaid data.
- Language
- English
- Date published
- 10/05/2013
- Academic Unit
- Statistics and Actuarial Science; Preventive and Community Dentistry; Health Management and Policy; Economics; Biostatistics; Injury Prevention Research Center; Public Policy Center (Archive); Community and Behavioral Health; University College Courses
- Record Identifier
- 9983557357002771
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