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Plan Type and Opioid Prescriptions for Children in Medicaid
Journal article   Peer reviewed

Plan Type and Opioid Prescriptions for Children in Medicaid

Jordan Banks, Courtney Hill and Donald L. Chi
Medical care, Vol.59(5), pp.386-392
05/01/2021
DOI: 10.1097/MLR.0000000000001504
PMCID: PMC8026560
PMID: 33528236
url
https://www.ncbi.nlm.nih.gov/pmc/articles/8026560View
Open Access

Abstract

Background: Opioids are generally an inappropriate acute pain management strategy in children, particularly because of the risk for diversion and subsequent misuse and abuse. Objectives: To examine associations between Medicaid plan type [coordinated care organization (CCO), managed care (MC), fee-for-service (FFS)] and whether a child received an opioid prescription. Research Design: Secondary analysis of Oregon Medicaid data (January 1, 2016 to December 31, 2017). Subjects: Medicaid-enrolled children ages 0-17 (N=200,169). Measures: There were 2 outcomes: whether a child received an opioid prescription from (a) any health provider or (b) from a visit to the dentist. Predictor variables included Medicaid plan type, age, sex, race, and ethnicity. Results: About 6.7% of children received an opioid from any health provider and 1.2% received an opioid from a dentist visit. Children in a CCO were significantly more likely than children in a MC (P<0.01) or FFS (P=0.02) plan to receive an opioid from any health provider. Children in a CCO were also significantly more likely than children in MC or FFS to receive an opioid from a dentist visit (P<0.01). Conclusions: Pediatric opioid prescriptions vary by plan type. Future efforts should identify reasons why Medicaid-enrolled children in a CCO plan are more likely to be prescribed opioids.
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