Funded Projects

(SDAS) Absence of Primary Care in High-Intensity Children with Special Health Care Needs

Grantee: Children's Hospital Corporation, The
Principal Investigator: Jay G Berry
Project Number: R40MC29443
Project Date: 04/01/2016

Final Report

(SDAS) Absence of Primary Care in High-Intensity Children with Special Health Care Needs Final Report (PDF)

Age group(s)

• Perinatal/Infancy (0-12 months)
• Toddlerhood (13-35 months)
• Early Childhood (3-5 years)
• Middle Childhood (6-11 years)
• Adolescence (12-18 years)

Targeted/Underserved Population

• African American
• Asian/Pacific Islander
• Hispanic/Latino
• Native American/Alaskan Native

Abstract

In response to HRSA-16-029 [R40 MCH Secondary Analysis Studies (SDAS)] of the R40 Maternal and Child Health Research Program, this project will address a major problem in the U.S. pediatric health care system for an extremely vulnerable population of children with special health care needs: those who have high-intensity, complex chronic conditions. Despite decades of effort promoting access and use of primary care, recent studies suggest that up to 40% of these children using Medicaid do not have an office visit with their primary care physician annually. This project will fill critical needs in knowledge for high-intensity children with special health care needs (HI-CSHCN) in Medicaid by (1) distinguishing which children, by their demographic and chronic condition profile, are the most likely to not use primary care; and (2) assessing the impact of underusing primary care on hospital and emergency department use. To achieve those aims, we will conduct a retrospective, longitudinal analysis of ~225,150 HI-CSHCN ages 0-18 years enrolled in 35 geographically-diverse state Medicaid programs in 2011 that are included in the Medicaid Analytic eXtract (MAX) database. We will use multivariable regression as well as classification and regression tree (CART) analysis to achieve the aims. The project relates directly to MCHB Strategic Research Issue I ("Public health service systems and infrastructures at the community, state, and national levels as they apply to different maternal and child health populations") and III ("Services and systems to assure quality of care for MCH populations").