Browsing by Subject "Medicaid"
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Item Dental visits in Medicaid-enrolled youth with mental illness: an analysis of administrative claims data(BioMed Central Ltd., 2020-12-11) Stockbridge, Erica L.; Dhakal, Eleena; Griner, Stacey B.; Loethen, Abiah D.; West, Joseph F.; Vera, Joseph W.; Nandy, KarabiBACKGROUND: State Medicaid plans across the United States provide dental insurance coverage to millions of young persons with mental illness (MI), including those with attention deficit hyperactivity disorder (ADHD), depression, anxiety, bipolar disorder, and schizophrenia. There are significant oral health challenges associated with MI, and providing dental care to persons with MI while they are young provides a foundation for future oral health. However, little is known about the factors associated with the receipt of dental care in young Medicaid enrollees with MI. We aimed to identify mental and physical health and sociodemographic characteristics associated with dental visits among this population. METHODS: We retrospectively analyzed administrative claims data from a Medicaid specialty health plan (September 2014 to December 2015). All enrollees in the plan had MI and were >/= 7 years of age; data for enrollees aged 7 to 20 years were analyzed. We used two-level, mixed effects regression models to explore the relationships between enrollee characteristics and dental visits during 2015. RESULTS: Of 6564 Medicaid-enrolled youth with MI, 29.0% (95% CI, 27.9, 30.1%) had one or more visits with a dentist or dental hygienist. Within youth with MI, neither anxiety (Adjusted odds ratio [AOR] = 1.15, p = 0.111), post-traumatic stress disorder (AOR = 1.31, p = 0.075), depression (AOR = 1.02, p = 0.831), bipolar disorder (AOR = 0.97, p = 0.759), nor schizophrenia (AOR = 0.83, p = 0.199) was associated with dental visits in adjusted analyses, although having ADHD was significantly associated with higher odds of dental visits relative to not having this condition (AOR = 1.34, p < 0.001). Age, sex, race/ethnicity, language, and education were also significantly associated with visits (p < 0.05 for all). CONCLUSIONS: Dental utilization as measured by annual dental visits was lower in Medicaid-enrolled youth with MI relative to the general population of Medicaid-enrolled youth. However, utilization varied within the population of Medicaid-enrolled youth with MI, and we identified a number of characteristics significantly associated with the receipt of dental services. By identifying these variations in dental service use this study facilitates the development of targeted strategies to increase the use of dental care in - and consequently improve the current and long-term wellbeing of - the vulnerable population of Medicaid-enrolled youth with MI.Item Health Care Access Patterns in Relation to Ethnic/Racial and Health Insurance Status at an Osteopathic Hospital for 1998 through 2001(2003-12-01) Mego, Charles B.W.; Lurie, Sue; Balcazar, Hector; TrevinoMego, III, Charles B.W., Health Care Access Patterns in Relation to Ethnic/Racial and Health Insurance Status at an Osteopathic Hospital for 998 through 2001. Doctor of Public Health (Social and Behavioral Sciences), December 2003, 106 p.p., 25 tables, 5 illustrations, references, 44 titles. The patient population of the Osteopathic Health System of Texas (OHST), an academic health center with a 256-bed teaching hospital, was analyzed for health care access as measured by health services utilization in 1998 through 2001. This study explored the question of whether there was less health care access among minorities than among the White non-Hispanic majority within the patient population at OHST. The Tarrant County population was compared to OHST’s population demographics. This assessment determined which Ethnic/Racial groups had the highest medical services utilization and their payment methods. Patient data obtained from the OHST’s Meditech database was analyzed using Epi-Info. White non-Hispanics made up over fifty percent of the Emergency Room (ER), Inpatient and Outpatient service utilization in 1998 through 2001. The Outpatient component made up just over fifty percent of the OHST’s patient. African-Americans were over represented in the ER, Inpatient, and Outpatient service components relative to the Tarrant County demographics for 1998 through 2001. The Hispanic ER Managed Care category increased 7% and confirmed a growth rate of 29% more ER Managed Care in 2001, as compared to 1998 (URR=1.29, [1.24-`.35], x2 = 142.49, p [less than] .01). The Hispanic ER Medicaid category decreased 4.1% and indicated a reduced growth rate of 17% less ER Medicaid in 2001 as compared to 1998 (URR = 0.83, [0.79-0/87], x2 = 57.69, p,.01). The Hispanic Inpatient Managed Care category increased 13.2% and revealed a positive growth rate with 52% more Inpatient Managed Care in 2001 as compared to 1998 (URR=1.52, [1.44-1.61]. x2 = 224.92, p [less than] .01). The Hispanic Inpatient Medicaid category decreased 14.4% and showed a reduced growth rate of 38% less Inpatient Medicaid in 2001 as compared to 1998 (URR=0.62, [0.59-0.66], x2=274.58, p [less than] .01). The Hispanic and the Other groups relied heavily upon ER Self Pay, with a general decrease in Medicaid coverage and an increase in Managed Care. The Hispanic and Other groups have medical needs that are being neglected at OHST, and may lead to serious health problems that could be more costly if still treatable.Item Population Characteristics Suggest Modifications to Proposed Pediatric Asthma Intervention Program(1998-08-01) DeMoss, Margaret W.; Ramirez, Gilbert; Urrutia-Rojas, Ximena; Coggin, ClaudiaDeMoss, Margaret W., Population Characteristics Suggest Modifications to Proposed Pediatric Asthma Intervention Program. Master of Public Health, August, 1998, 57 pp., 4 tables, 1 illustration, 2 appendices, reference list, 46 titles. Asthma is the most common chronic childhood disease affecting almost 5 million children in this country. The children most as risk for developing asthma come from low income, minority, and urban families. This studies examines a proposed pediatric asthma intervention program targeting Tarrant County area Medicaid clients. The purpose of this study is to define different subgroups and preferences among those clients and to recommend modifications that are likely to improve program outcomes. Recommendations were based on information gathered from interviews with 70 families, all having at least one child with asthma. Specific interests in learning more about asthma as well as learning preferences are tested for association with a variety of family characteristics. Although no statistically significant results were determined for subgroups, descriptive findings reveal that a large minority of respondents are interested in more information about asthma, but not necessarily by the means proposed. The study also suggests special needs for families with very young children, for those with adult asthma, and for Hispanics.Item The Association Between Medical Insurance Coverage, In-Hospital Case Fatality Rate, and Length of Hospital Stay Following Admission for Acute Myocardial Infarction in Texas Hospitals(2002-07-01) Boppana, Dinesh; Rene, Antonio A.; Blakley, Sally; Mains, Doug A.Dinesh Boppana, The Association Between Medical Insurance Coverage, In-hospital Case Fatality Rate and Length of Hospital Stay Following Admission for Acute Myocardial Infarction in Texas Hospitals. Master of Public Health, July 2002, 53pp., 22 tables, bibliography, 63 titles. This study reports the possible association between type of medical insurance coverage, in-hospital case fatality rates and length of hospital stay following admission for acute myocardial infarction (AMI) in Texas hospitals for the year of 1999. Methods. The data sources was the Texas Health Care Information Council public use data file. Crude and multivariable-adjusted analyses were used to examine the relation between type of medical insurance coverage, length of hospital stay and in-hospital case-fatality rates following AMI. Results. Relative to the referent group of private or commercial insurance patients (odds ratio, 1.0) the multi-variable adjusted odds for dying during acute hospitalization were 1.98 (95% CI, 1.53-2.52) for Medicaid, 1.45 (95% CI, 1.27-1.64) for Medicare. The mean length of hospital stay in days after excluding patients with a prolonged hospitalization was 8.53 (95% CI, 7.93-9.14) for Medicaid, 6.75 (95% CI, 6.52-6.95) for Medicare, and 5.58 (95% CI, 5.37-5.79) for commercial insurance. Conclusions. The findings suggest that patient enrolled in Medicaid and Medicare insurance program had increased in-hospital mortality, and higher length of hospital stay following admission with AMI when compared to the patients enrolled in commercial insurance.