Are Outcomes and Care Processes for Preterm Neonates Influenced by Health Insurance Status?

Brandon, Gwieneverea D; Adeniyi-Jones, Susan; Kirkby, Sharon; Webb, David; Culhane, Jennifer F.; Greenspan, Jay S.

doi:10.1542/peds.2008-1318

Cited by 28 publications

(21 citation statements)

References 18 publications

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“…20 Also, a higher prevalence of pregnancy complications, prematurity, and other neonatal complications could contribute to the high rates of LRTI in children ,1 year old in this population. 21 We also identified a higher frequency of underlying medical conditions and multiple medical conditions among children hospitalized for LRTI with Medicaid versus commercial insurance, a finding supported by other reports and likely contributing to the higher rates of hospitalization for LRTI and severe LRTI. 22 Approximately 13% of Medicaid children were eligible based on a disability.…”

Section: Resultssupporting

confidence: 84%

Hospitalizations for Severe Lower Respiratory Tract Infections

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Lower respiratory tract infections (LRTIs), including pneumonia, are in the top 10 causes of death among children in the United States. In high-income countries, 3% to 14% of LRTI hospitalizations have been reported to require admission to an ICU. During 2007During -2011, approximately 31 289 hospitalizations for severe LRTI occurred in children each year in the United States. Children ,1 year of age had the highest rates of severe LRTI and accounted for 30% of severe LRTI hospitalizations. abstract BACKGROUND: Hospitalization for lower respiratory tract infections (LRTIs) among children have been well characterized. We characterized hospitalizations for severe LRTI among children. WHAT THIS STUDY ADDS: METHODS:We analyzed claims data from commercial and Medicaid insurance enrollees (MarketScan) ages 0 to 18 years from 2007 to 2011. LRTI hospitalizations were identified by the first 2 listed International Classification of Diseases, Ninth Revision discharge codes; those with ICU admission and/or receiving mechanical ventilation were defined as severe LRTI. Underlying conditions were determined from out-and inpatient discharge codes in the preceding year. We report insurance specific and combined rates that used both commercial and Medicaid rates and adjusted for age and insurance status. RESULTS:During 2007-2011, we identified 16 797 and 12 053 severe LRTI hospitalizations among commercial and Medicaid enrollees, respectively. The rates of severe LRTI hospitalizations per 100 000 person-years were highest in children aged ,1 year (commercial: 244; Medicaid: 372, respectively), and decreased with age. Among commercial enrollees, $1 condition increased the risk for severe LRTI (1 condition: adjusted relative risk, 2.68; 95% confidence interval, 2.58-2.78; 3 conditions: adjusted relative risk, 4.85; 95% confidence interval, 4.65-5.07) compared with children with no medical conditions. Using commercial/Medicaid combined rates, an estimated 31 289 hospitalizations for severe LRTI occurred each year in children in the United States.CONCLUSIONS: Among children, the burden of hospitalization for severe LRTI is greatest among children aged ,1 year. Children with underlying medical conditions are at greatest risk for severe LRTI hospitalization. Pediatrics 2014;134:546-554 AUTHORS:

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Section: Resultssupporting

confidence: 84%

Hospitalizations for Severe Lower Respiratory Tract Infections

et al. 2014

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“…53,54 A recent study that examined the gestational age distributions for preterm births to Medicaid recipients on managed care and privately insured women found no differences in gestational age at birth, although babies delivered to women on private insurance had a higher mean birth weight. 55 Enhanced services offered by some Medicaid programs have reduced preterm births and low birth weights in regions and states that have lower prematurity and neonatal death rates (Table 2), a correlation that is not unexpected. Of concern, such programs are not as uniformly successful in the Southeast and in states with the highest rates of preterm and low birth weight births.…”

Section: Discussionmentioning

confidence: 95%

Medicaid and Preterm Birth and Low Birth Weight: The Last Two Decades

Anum

Retchin

Strauss

2010

Journal of Women's Health

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Objectives: To determine if (1) birth outcomes among women on Medicaid differ significantly from outcomes of those with private insurance, after controlling for known risk factors, and (2) enhanced prenatal care influences care use and birth outcomes. Methods: This is a review of studies published between 1989 and 2009 that examined birth outcomes (1) between women on Medicaid and those with private insurance and (2) among Medicaid enrollees who received comprehensive prenatal care. Results: When corrected for risk variables, birth outcomes are not different between private insurance and Medicaid patients. The impact of comprehensive prenatal care programs on birth outcomes varies across states and regions. Conclusions: There is a need for critical evaluation of comprehensive programs in a regional and state context to determine opportunities for improvement.

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“…We hypothesized that safety-net hospitals may have fewer financial resources and thus be less likely to support DM programs, as Medicaid insurance status is associated with differences in NICU care. 20 Fourth, we evaluated the number of dedicated NICU lactation consultants because lactation consultant support is associated with NICU breastfeeding promotion, 21 and thus we hypothesized that increased lactation support may increase awareness of the benefits of DM for preterm infants. Finally, we assessed geographic region as a predictor of DM use because breastfeeding rates have been shown to vary by region.…”

Section: Discussionmentioning

confidence: 99%