Comparison of Parental Report of Blood Lead Testing In Children Enrolled in Medicaid with Medicaid Claims Data and Blood Lead Surveillance Reports

Abstract

The purposes of this study were to identify the congruence of blood lead testing based on parental self-reports with Medicaid claims and blood lead surveillance records, and to determine factors associated with agreement between parental reports of blood lead tests and Medicaid claims or blood lead surveillance records. Data were obtained from a cross-sectional mailed survey of a randomly selected sample of parents of children 1-2 years old enrolled in Medicaid (n=532) and from existing Medicaid claims and blood lead surveillance records. Fifty-six percent of survey respondents reported their child had a blood lead test completed. Of these, only 56% could be confirmed with Medicaid claims/blood lead surveillance data. Logistic regression analysis revealed the odds of blood lead testing per parental report confirmed with Medicaid claims/blood lead surveillance data were 2.6 times greater if the child had > or =3 provider visits, 2.5 times greater if parents reported receiving a reminder about blood lead testing, 2.2 times greater if parents reported receiving information about lead poisoning, 1.6 times greater if residing in an urban county, and 1.5 times greater if the child was more than 2 years old. In conclusion, parents are not always aware if their child had a blood lead test. Information and reminders about blood lead testing should be distributed to parents of young children enrolled in Medicaid and frequently reviewed by healthcare providers.

Effectiveness of a Pediatric Verbal Lead Exposure Screening Protocol in Emergency Department Patients

“…A study by Polivka et al suggested a greater likelihood of a child having BLL testing when the guardian was reminded through a letter, reminder card or phone call. 14,15 Patients seemed to prefer brochures or pamphlets. 15 Other factors that have improved BLL testing rates include receiving easy to read informational materials as well as videos with lead poisoning education.…”

“…15 Other factors that have improved BLL testing rates include receiving easy to read informational materials as well as videos with lead poisoning education. [14][15][16] Focus groups that looked at barriers to BLL testing showed that parents preferred to have all of their testing performed at the same facility and did not like to travel to multiple locations to have testing performed. 16 These parents also stated that they were hesitant to have testing done due to the traumatizing nature of multiple blood tests and immunizations for children.…”

“…In different study by Polivka et al, parental reporting of prior lead testing was compared to Medicaid claims and blood lead surveillance data. 14 They found that while 55.6% of respondents stated that the child had a BLL drawn, only 56.1% of these children actually had a record of a BLL; and of the 44.4% of respondents who claimed to not have had BLL testing, 22.9% had records of a prior BLL in the Medicaid or blood lead surveillance systems. 14 Many respondents reported that they were confused and did not know what tests had been performed on their children during each visit to the doctor's office.…”

“…14 They found that while 55.6% of respondents stated that the child had a BLL drawn, only 56.1% of these children actually had a record of a BLL; and of the 44.4% of respondents who claimed to not have had BLL testing, 22.9% had records of a prior BLL in the Medicaid or blood lead surveillance systems. 14 Many respondents reported that they were confused and did not know what tests had been performed on their children during each visit to the doctor's office. These findings emphasize the necessity for effective communication between physicians, nurses and healthcare staff and patients and caregivers.…”

Blood Lead Testing Among Medically Underserved and Socially Vulnerable Children in the United States 2012-2017

“…Parents do not always know whether their child had a blood lead test. 33 Second, because of the small sample size of the study, the generalizability of the results is limited. Third, the age cutoffs for a blood lead test in the HCPS and UDS are different from CDC data.…”