The 130th Annual Meeting of APHA

Abstract #50258

Mary Alice Lee, PhD¹, Amanda Learned, BA², and Katharine Carlino, MSW². (1) Children's Health Council, 60 Gillett Street, 2nd Floor, Hartford, CT 06105, (2) Children's Health Project/Maximus, 999 Asylum Ave, 2nd Floor, Hartford, CT 06040, 8605506744, malee@hfpg.org

Objectives: 1) To describe ambulatory care; 2) to identify children at greatest risk for not receiving care; and 3) to describe how findings have been used to develop interventions aimed at increasing access and utilization.

Methods: Children 12 to 19 who were continuously enrolled for a one-year period (n=42,553) were identified. Encounter data were searched for records corresponding to ambulatory care they received. Rates for well-child care, episodic care, and no care were determined. Differences in utilization associated with age and other sociodemographic or enrollment factors were evaluated. The effect of a medical home on emergency care utilization was estimated by comparing emergency visit rates for children who did and did not have well-child care.

Results: Most adolescents (77%) received some ambulatory care. Well-child visit rates declined with age for adolescent boys and girls; however, episodic visit rates increased with age for girls and decreased for boys. Adolescents who did not have well-child care were nearly twice as likely to have received emergency care as adolescents who did have well-child care (RRER/noWCC: ER/WCC=1.85 (95% CI: 1.75, 1.92).

Conclusion: Efforts to increase well-child visits in adolescence must be age- and gender-specific. Episodic visits are important opportunities for providing comprehensive care and risk assessment.

Implications for policy and practice: Administrative data can be used to develop collaborative approaches to increasing utilization.

Learning Objectives:

• To describe ambulatory care by adolescents enrolled in Connecticut's Medicaid managed care program;
• to identify children at greatest risk for not receiving care; and
• to describe how findings have been used to develop interventions aimed at increasing access and utilization.

Keywords: Adolescent Health, Medicaid Managed Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.