Background
Methods
Data Collection
Variables by domain | Definition of variables |
---|---|
Dependent variables | |
Utilization | Number of primary care visits |
Number of non-primary outpatient care (e.g., subspecialty care, behavioral health) | |
Number of prescription drug claims | |
Number of emergency department visits | |
Number of inpatient admissions | |
Quality | Well-child visits for two age groups: 3–6 years old and 12–17 years old Assessed based on CPT codes and ICD codes: CPT codes: 99,381–99,384, 99,391–99,394 (CPT codes for well-child visits by age: 0–15 months = 99,381, 99,382, 99,391, 99,392; 3–6 years = 99,382, 99,383, 99,392, 99,393; 12–17 years = 99,384, 99,394) ICD codes: V202, V700, V703, V705, V706, V708, V709 |
Avoidable or ambulatory care sensitive emergency department visits | |
Avoidable or ambulatory care sensitive hospital admissions Measured using the Agency for Healthcare Research and Quality Pediatric Quality Indicators [17] | |
Spending | Total amount calculated as a sum of payments from Medicaid and third-party payers |
Amount for each category of utilization calculated as a sum of payments from Medicaid and third-party payers | |
Independent variable | |
Health center or non-health center patient | Health center patients = individuals with more than half of primary care visits occurring at a health center* Non-health center patients = individuals with less than or equal to half of all primary care visits occurring at a health center or no primary care visits at a health center* Primary care visits Identifying using provider specialty and procedure codes CPT codes: 99,201–99205, 99,211–99,215, 99,381–99,387, 99,391–99,397 ICD codes: any Health center setting Determined using national provider identifier, claim type, and place of service in each claim |
Statistical Analyses
Characteristics / Covariates used for weighting | Crude | Overlap weight method | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Health Center n = 2,379,417 | Non-Health Center n = 18,507,232 | Mean difference | Standard error of mean difference | Standardized difference | Health Center n = 2,379,417 | Non-Health Center n = 18,507,232 | Mean difference | Standard error of mean difference | Standardized difference | |
No. (%) or mean (SD) | No. (%) or mean (SD) | No. (%) or mean (SD) | No. (%) or mean (SD) | |||||||
Female, # (%) | 1,176,939 (49.39) | 9,074,068 (48.95) | 0.44 | 0.5 | 0.88 | 927,684 (49.29) | 927,684 (49.29) | 0 | 0.5 | 0 |
Age, mean (SD) | 7.86 (5.02) | 7.78 (5.00) | 0.08 | 5.01 | 1.54 | 7.8 (4.47) | 7.8 (1.6) | 0 | 3.36 | 0 |
Race/ethnicity, # (%) | ||||||||||
White | 554,656 (23.27) | 7,159,942 (38.62) | -15.34 | 0.46 | 33.66 | 476,232 (25.30) | 476,232 (25.30) | 0 | 0.43 | 0 |
Black | 477,466 (20.03) | 3,951,305 (21.31) | -1.28 | 0.4 | 3.15 | 385,242 (20.47) | 385,242 (20.47) | 0 | 0.4 | 0 |
American Indian or Alaska Native | 32,695 (1.37) | 229,922 (1.24) | 0.13 | 0.11 | 1.16 | 27,004 (1.43) | 27,004 (1.43) | 0 | 0.12 | 0 |
Asian | 60,817 (2.55) | 447,471 (2.41) | 0.14 | 0.16 | 0.89 | 49,599 (2.64) | 49,599 (2.64) | 0 | 0.16 | 0 |
Hispanic/Latino or Hispanic and > 1 race | 971,934 (40.78) | 4,986,916 (26.90) | 13.88 | 0.47 | 29.66 | 726,751 (38.61) | 726,751 (38.61) | 0 | 0.49 | 0 |
Native Hawaiian or other Pacific Islander | 20,875 (0.88) | 87,280 (0.47) | 0.41 | 0.08 | 4.96 | 15,417 (0.82) | 15,417 (0.82) | 0 | 0.09 | 0 |
Non-Hispanic and > 1 race | 13,354 (0.56) | 150,640 (0.81) | -0.25 | 0.08 | 3.05 | 11,462 (0.61) | 11,462 (0.61) | 0 | 0.08 | 0 |
Unknown/Missing | 251,473 (10.55) | 1,527,267 (8.24) | 2.31 | 0.29 | 7.94 | 190,418 (10.12) | 190,418 (10.12) | 0 | 0.3 | 0 |
Urban, # (%) | 2,001,281 (84.04) | 14,887,775 (80.35) | 3.69 | 0.38 | 9.66 | 1,587,170 (84.33) | 1,587,170 (84.33) | 0 | 0.36 | 0 |
Distance to nearest health center, kilometers, mean (SD) | 14.92 (20.86) | 22.30 (25.54) | -7.38 | 23.32 | 31.67 | 15.63 (19.46) | 15.63 (5.75) | 0 | 14.35 | 0 |
Medicaid eligibility, # (%) | ||||||||||
Child | 2,296,298 (96.35) | 17,576,244 (94.80) | 1.55 | 0.21 | 7.56 | 1,808,518 (96.09) | 1,808,518 (96.09) | 0 | 0.19 | 0 |
Disabled | 84,428 (3.54) | 911,120 (4.91) | -1.37 | 0.2 | 6.82 | 71,557 (3.80) | 71,557 (3.80) | 0 | 0.19 | 0 |
Demonstration projects | 2,544 (0.11) | 53,379 (0.29) | -0.18 | 0.04 | 4.08 | 2,051 (0.11) | 2,051 (0.11) | 0 | 0.03 | 0 |
Temporary Assistance for Needy Families (TANF) eligible, # (%) | 425,187 (17.84) | 1,895,533 (10.22) | 7.62 | 0.35 | 22.06 | 315,761 (16.78) | 315,761 (16.78) | 0 | 0.37 | 0 |
Eligible months, mean (SD) | ||||||||||
Total | 11.40 (1.43) | 11.38 (1.46) | 0.02 | 1.44 | 1.71 | 11.41 (1.27) | 11.41 (0.46) | 0 | 0.95 | 0 |
Managed care | 8.07 (4.97) | 8.57 (4.67) | -0.5 | 4.83 | 10.34 | 8.04 (4.43) | 8.04 (1.60) | 0 | 3.33 | 0 |
Chronic Disease Payment System Rx score, mean (SD) | 0.99 (1.77) | 1.17 (2.32) | -0.18 | 2.07 | 8.65 | 1.02 (1.64) | 1.02 (0.55) | 0 | 1.22 | 0 |
State, # (%) | ||||||||||
AK | 5645 (0.2) | 49,445 (0.3) | -0.03 | 0.05 | 0.6 | 5032 (0.3) | 5032 (0.3) | 0 | 0.05 | 0 |
AL | 30,598 (1.3) | 369,129 (2) | -0.71 | 0.13 | 5.57 | 27,611 (1.5) | 27,611 (1.5) | 0 | 0.12 | 0 |
AR | 16 (0) | 1399 (0) | -0.01 | 0.01 | 1.07 | 16 (0) | 16 (0) | 0 | 0 | 0 |
AZ | 34,037 (1.4) | 464,327 (2.5) | -1.08 | 0.14 | 7.76 | 31,338 (1.7) | 31,338 (1.7) | 0 | 0.13 | 0 |
CA | 637,844 (26.8) | 1,831,440 (9.9) | 16.89 | 0.38 | 44.73 | 467,866 (24.9) | 467,866 (24.9) | 0 | 0.43 | 0 |
CO | 65,994 (2.8) | 178,492 (1) | 1.81 | 0.14 | 13.38 | 47,504 (2.5) | 47,504 (2.5) | 0 | 0.16 | 0 |
CT | 52,070 (2.2) | 150,110 (0.8) | 1.38 | 0.12 | 11.34 | 37,005 (2) | 37,005 (2) | 0 | 0.14 | 0 |
DC | 13,698 (0.6) | 46,143 (0.2) | 0.33 | 0.06 | 5.09 | 10,497 (0.6) | 10,497 (0.6) | 0 | 0.07 | 0 |
DE | 262 (0) | 71,155 (0.4) | -0.37 | 0.04 | 8.41 | 261 (0) | 261 (0) | 0 | 0.01 | 0 |
FL | 66,818 (2.8) | 1,106,803 (6) | -3.17 | 0.2 | 15.51 | 62,682 (3.3) | 62,682 (3.3) | 0 | 0.18 | 0 |
GA | 26,286 (1.1) | 666,914 (3.6) | -2.49 | 0.15 | 16.52 | 25,025 (1.3) | 25,025 (1.3) | 0 | 0.11 | 0 |
HI | 7203 (0.3) | 57,224 (0.3) | -0.01 | 0.06 | 0.12 | 6319 (0.3) | 6319 (0.3) | 0 | 0.06 | 0 |
IA | 19,846 (0.8) | 174,461 (0.9) | -0.11 | 0.09 | 1.15 | 17,269 (0.9) | 17,269 (0.9) | 0 | 0.1 | 0 |
ID | 9020 (0.4) | 109,775 (0.6) | -0.21 | 0.07 | 3.07 | 8245 (0.4) | 8245 (0.4) | 0 | 0.07 | 0 |
IL | 187,651 (7.9) | 845,569 (4.6) | 3.31 | 0.24 | 13.75 | 148,754 (7.9) | 148,754 (7.9) | 0 | 0.27 | 0 |
IN | 51,311 (2.2) | 415,390 (2.2) | -0.09 | 0.15 | 0.6 | 44,875 (2.4) | 44,875 (2.4) | 0 | 0.15 | 0 |
KS | 6779 (0.3) | 160,384 (0.9) | -0.58 | 0.08 | 7.69 | 6423 (0.3) | 6423 (0.3) | 0 | 0.06 | 0 |
KY | 16,181 (0.7) | 355,569 (1.9) | -1.24 | 0.11 | 10.96 | 15,333 (0.8) | 15,333 (0.8) | 0 | 0.09 | 0 |
LA | 22,713 (1) | 489,490 (2.6) | -1.69 | 0.13 | 12.73 | 21,565 (1.1) | 21,565 (1.1) | 0 | 0.11 | 0 |
MA | 34,278 (1.4) | 343,301 (1.9) | -0.41 | 0.13 | 3.25 | 30,285 (1.6) | 30,285 (1.6) | 0 | 0.13 | 0 |
MD | 50,574 (2.1) | 34,977 (0.2) | 1.93 | 0.11 | 18.17 | 19,844 (1.1) | 19,844 (1.1) | 0 | 0.1 | 0 |
ME | 17,106 (0.7) | 71,792 (0.4) | 0.33 | 0.07 | 4.46 | 13,620 (0.7) | 13,620 (0.7) | 0 | 0.08 | 0 |
MI | 57,672 (2.4) | 666,954 (3.6) | -1.18 | 0.17 | 6.9 | 52,295 (2.8) | 52,295 (2.8) | 0 | 0.16 | 0 |
MN | 1631 (0.1) | 283,322 (1.5) | -1.46 | 0.09 | 16.46 | 1614 (0.1) | 1614 (0.1) | 0 | 0.03 | 0 |
MO | 10,978 (0.5) | 366,965 (2) | -1.52 | 0.11 | 13.87 | 10,596 (0.6) | 10,596 (0.6) | 0 | 0.07 | 0 |
MS | 24,609 (1) | 254,992 (1.4) | -0.34 | 0.11 | 3.14 | 21,973 (1.2) | 21,973 (1.2) | 0 | 0.11 | 0 |
MT | 6092 (0.3) | 47,993 (0.3) | 0 | 0.05 | 0.06 | 5212 (0.3) | 5212 (0.3) | 0 | 0.05 | 0 |
NC | 16,982 (0.7) | 760,251 (4.1) | -3.39 | 0.15 | 22.24 | 16,519 (0.9) | 16,519 (0.9) | 0 | 0.09 | 0 |
ND | 1681 (0.1) | 24,016 (0.1) | -0.06 | 0.03 | 1.87 | 1524 (0.1) | 1524 (0.1) | 0 | 0.03 | 0 |
NE | 4362 (0.2) | 121,145 (0.7) | -0.47 | 0.06 | 7.29 | 4144 (0.2) | 4144 (0.2) | 0 | 0.05 | 0 |
NH | 6365 (0.3) | 65,268 (0.4) | -0.08 | 0.06 | 1.53 | 5721 (0.3) | 5721 (0.3) | 0 | 0.06 | 0 |
NJ | 14,581 (0.6) | 477,756 (2.6) | -1.96 | 0.12 | 15.74 | 14,076 (0.7) | 14,076 (0.7) | 0 | 0.09 | 0 |
NM | 17,799 (0.7) | 220,452 (1.2) | -0.44 | 0.1 | 4.52 | 16,323 (0.9) | 16,323 (0.9) | 0 | 0.09 | 0 |
NV | 2739 (0.1) | 40,595 (0.2) | -0.1 | 0.04 | 2.55 | 2498 (0.1) | 2498 (0.1) | 0 | 0.04 | 0 |
NY | 198,985 (8.3) | 1,232,610 (6.6) | 1.7 | 0.26 | 6.46 | 168,058 (8.9) | 168,058 (8.9) | 0 | 0.29 | 0 |
OH | 79,221 (3.3) | 816,489 (4.4) | -1.08 | 0.19 | 5.6 | 71,519 (3.8) | 71,519 (3.8) | 0 | 0.19 | 0 |
OK | 21,784 (0.9) | 339,853 (1.8) | -0.92 | 0.12 | 7.9 | 20,152 (1.1) | 20,152 (1.1) | 0 | 0.1 | 0 |
OR | 21,181 (0.9) | 197,398 (1.1) | -0.18 | 0.1 | 1.79 | 18,801 (1) | 18,801 (1) | 0 | 0.1 | 0 |
PA | 24,659 (1) | 320,468 (1.7) | -0.69 | 0.12 | 5.95 | 22,582 (1.2) | 22,582 (1.2) | 0 | 0.11 | 0 |
RI | 10,563 (0.4) | 42,217 (0.2) | 0.22 | 0.06 | 3.73 | 7979 (0.4) | 7979 (0.4) | 0 | 0.06 | 0 |
SC | 49,257 (2.1) | 364,546 (2) | 0.1 | 0.14 | 0.72 | 42,403 (2.3) | 42,403 (2.3) | 0 | 0.15 | 0 |
SD | 7104 (0.3) | 45,624 (0.2) | 0.05 | 0.05 | 1 | 6061 (0.3) | 6061 (0.3) | 0 | 0.06 | 0 |
TN | 15,391 (0.6) | 529,099 (2.9) | -2.21 | 0.13 | 16.9 | 14,919 (0.8) | 14,919 (0.8) | 0 | 0.09 | 0 |
TX | 125,742 (5.3) | 2,014,116 (10.9) | -5.59 | 0.27 | 20.62 | 117,713 (6.3) | 117,713 (6.3) | 0 | 0.24 | 0 |
UT | 4266 (0.2) | 127,038 (0.7) | -0.51 | 0.07 | 7.72 | 4082 (0.2) | 4082 (0.2) | 0 | 0.05 | 0 |
VA | 9195 (0.4) | 432,323 (2.3) | -1.95 | 0.12 | 16.87 | 8965 (0.5) | 8965 (0.5) | 0 | 0.07 | 0 |
VT | 8365 (0.4) | 40,515 (0.2) | 0.13 | 0.05 | 2.49 | 6742 (0.4) | 6742 (0.4) | 0 | 0.06 | 0 |
WA | 239,009 (10) | 326,852 (1.8) | 8.27 | 0.23 | 35.64 | 132,028 (7) | 132,028 (7) | 0 | 0.26 | 0 |
WI | 37,576 (1.6) | 326,383 (1.8) | -0.18 | 0.13 | 1.43 | 32,993 (1.8) | 32,993 (1.8) | 0 | 0.13 | 0 |
WV | 9155 (0.4) | 28,904 (0.2) | 0.23 | 0.05 | 4.4 | 6881 (0.4) | 6881 (0.4) | 0 | 0.06 | 0 |
WY | 396 (0) | 33,310 (0.2) | -0.16 | 0.03 | 5.21 | 386 (0) | 386 (0) | 0 | 0.01 | 0 |
Results
Characteristics | All Medicaid | Fee-for-service only Medicaid | ||
---|---|---|---|---|
Health Center | Non-Health Center | Health Center | Non-Health Center | |
(n = 2,383,270) | (n = 18,540,743) | (n = 557,912) | (n = 3,530,021) | |
No. (%) or mean (SD) | No. (%) or mean (SD) | No. (%) or mean (SD) | No. (%) or mean (SD) | |
Female, # (%) | 1,176,939 (49.39) | 9,074,068 (48.95) | 274,498 (49.22) | 1,701,558 (48.23) |
Age category, # (%) | ||||
0–15 months | 177,486 (7.45) | 1,396,598 (7.53) | 38,637 (6.93) | 217,796 (6.17) |
16 months-2 years | 326,971 (13.72) | 2,597,653 (14.01) | 71,219 (12.77) | 436,491 (12.37) |
3–6 years | 524,278 (22.00) | 4,101,463 (22.12) | 117,323 (21.03) | 733,656 (20.78) |
7–11 years | 758,850 (31.84) | 5,915,859 (31.91) | 177,025 (31.73) | 1,168,935 (33.11) |
12–17 years | 595,685 (25.00) | 4,529,170 (24.43) | 153,708 (27.55) | 973,143 (27.57) |
Race/ethnicity, # (%) | ||||
White | 554,656 (23.27) | 7,159,942 (38.62) | 147,966 (26.52) | 1,515,561 (42.93) |
Black | 477,466 (20.03) | 3,951,305 (21.31) | 124,561 (22.33) | 694,665 (19.68) |
American Indian or Alaska Native | 32,695 (1.37) | 229,922 (1.24) | 18,812 (3.37) | 101,815 (2.88) |
Asian | 60,817 (2.55) | 447,471 (2.41) | 11,013 (1.97) | 54,647 (1.55) |
Hispanic/Latino or Hispanic and > 1 race | 971,934 (40.78) | 4,986,916 (26.90) | 150,455 (26.97) | 659,878 (18.69) |
Native Hawaiian or other Pacific Islander | 20,875 (0.88) | 87,280 (0.47) | 1,578 (0.28) | 6,272 (0.18) |
Non-Hispanic and > 1 race | 13,354 (0.56) | 150,640 (0.81) | 2475 (0.44) | 20,255 (0.57) |
Unknown/Missing | 251,473 (10.55) | 1,527,267 (8.24) | 101,052 (18.11) | 476,928 (13.51) |
Census region, # (%) | ||||
Midwest | 465,812 (19.55) | 4,246,702 (22.90) | 195,215 (34.99) | 1,096,501 (31.06) |
Northeast | 366,972 (15.40) | 2,744,037 (14.80) | 126,581 (22.69) | 584,428 (16.56) |
South | 499,261 (20.95) | 7,865,663 (42.42) | 88,218 (15.81) | 1,317,225 (37.31) |
West | 1,051,225 (44.11) | 3,684,341 (19.87) | 147,898 (26.51) | 531,867 (15.10) |
Urban, # (%) | 2,001,281 (84.04) | 14,887,775 (80.35) | 455,453 (81.73) | 2,682,946 (76.06) |
Distance to nearest health center, kilometers, mean (SD) | 14.92 (20.86) | 22.30 (25.54) | 17.03 (26.80) | 26.37 (30.06) |
Temporary Assistance for Needy Families (TANF) eligible, # (%) | 425,187 (17.84) | 1,895,533 (10.22) | 55,916 (10.02) | 170,700 (4.84) |
Medicaid eligibility, # (%) | ||||
Child | 2,291,934 (96.17) | 17,542,569 (94.62) | 530,403 (95.07) | 3,224,660 (91.35) |
Disabled | 88,792 (3.73) | 1,051,225 (5.10) | 27,287 (2.89) | 302,033 (8.56) |
Demonstration projects | 2,544 (0.11) | 53,379 (0.29) | 222 (0.04) | 3,328 (0.09) |
Eligible months, mean (SD) | ||||
Total | 11.41 (1.43) | 11.38 (1.46) | 11.43 (1.44) | 11.46 (1.40) |
Fee for service | 3.33 (4.81) | 2.81 (4.52) | 11.43 (1.44) | 11.46 (1.40) |
Managed care | 8.07 (4.97) | 8.57 (4.67) | 0 (0) | 0 (0) |
Chronic Disease Payment System Rx score, mean (SD) | 0.99 (1.77) | 1.17 (2.32) | 1.11 (2.10) | 1.36 (2.93) |
Demographics
Primary analysis (Table 4)
Outcome | Crudea | Adjusteda,b | ||||
---|---|---|---|---|---|---|
HC (n = 2,383,270) | Non-HC (n = 18,540,743) | IRR / RRc (95% CI) | HC (n = 2,383,270) | non-HC (n = 18,540,743) | IRR / RRc (95% CI) | |
Utilization, per year – mean (95% CI) | ||||||
Primary care visits | 5.352 | 4.582 | 1.168 | 5.301 | 4.402 | 1.204 |
(5.346,5.357) | (4.580,4.584) | (1.167,1.169) | (5.298,5.304) | (4.400,4.403) | (1.203,1.205) | |
Non-primary care outpatient visits | 4.0581 | 5.8028 | 0.699 | 4.207 | 4.934 | 0.853 |
(4.0455,4.0707) | (5.7964,5.8092) | (0.697,0.702) | (4.202,4.213) | (4.928,4.940) | (0.851,0.854) | |
ED visits | 0.633 | 0.6756 | 0.937 | 0.634 | 0.6518 | 0.972 |
(0.632,0.635) | (0.6751,0.6762) | (0.935,0.940) | (0.633,0.635) | (0.6513,0.6523) | (0.971,0.974) | |
Inpatient admissions | 0.0668 | 0.0847 | 0.777 | 0.0659 | 0.0799 | 0.825 |
(0.0654, 0.0663) | (0.0845, 0.0849) | (0.772,0.782) | (0.0656, 0.0663) | (0.0797, 0.0801) | (0.821,0.830) | |
Prescription claims | 4.686 | 6.877 | 0.681 | 4.798 | 6.102 | 0.786 |
(4.678,4.695) | (6.873,6.881) | (0.680,0.683) | (4.794,4.802) | (6.099,6.106) | (0.785,0.787) | |
Utilization, per year – No. (%) | ||||||
Children with 1 + ED visits | 797,624 (33.47) | 6,536,406 (35.25) | 0.949 (0.948,0.951) | 638,131 (33.91) | 624,581 (33.19) | 1.022 (1.019,1.027) |
Children with 1 + inpatient admissions | 109,022 (4.57) | 1,063,004 (5.73) | 0.7978 (0.793,0.803) | 90,365 (4.80) | 92,575 (4.91) | 0.976 (0.967,0.985) |
Quality, per year – No. (%) | ||||||
3–6 year old with well-child visit | 395,919 (65.68) | 2,742,950 (58.49) | 1.123 (1.121,1.125) | 310,621 (65.58) | 270,629 (57.21) | 1.146 (1.143,1.150) |
12–17 year old with well-child visit | 262,994 (49.51) | 1,887,449 (46.90) | 1.056 (1.053,1.059) | 208,982 (49.91) | 194,649 (46.48) | 1.074 (1.069,1.078) |
Children with ambulatory care sensitive ED visits | 424,547 (17.81) | 3,300,425 (17.80) | 1.001 (0.998,1.004) | 339,838 (18.06) | 316,539 (16.82) | 1.074 (1.069,1.078) |
Children with ambulatory care sensitive hospitalizations | 3,853 (0.16) | 33,511 (0.18) | 0.895 (0.865,0.925) | 3,101 (0.16) | 3,353 (0.18) | 0.925 (0.881,0.971) |
Fee-for-service only (Table 5)
Outcome | Crudea | Adjusteda.b | ||||
---|---|---|---|---|---|---|
HC (n = 557,912) | Non-HC (n = 3,530,021) | IRR / RRc (95% CI) | HC (n = 557,912) | Non-HC (n = 3,530,021) | IRR / RRc (95% CI) | |
Utilization, per year – mean (95% CI) | ||||||
Primary care visits | 4.569 | 4.879 | 0.937 | 4.576 | 4.614 | 0.992 |
(4.559, 4.579) | (4.875, 4.883) | (0.934, 0.939) | (4.569,4.582) | (4.610,4.618) | (0.990, 0.993) | |
Non-primary care outpatient visits | 5.866 | 9.790 | 0.599 | 6.1367 | 7.426 | 0.826 |
(5.829, 5.903) | (9.766, 9.815) | (0.595, 0.603) | (6.118, 6.154) | (7.405, 7.447) | (0.823, 0.830) | |
ED visits | 0.677 | 0.675 | 1.002 | 0.677 | 0.655 | 1.034 |
(0.674, 0.680) | (0.674, 0.677) | (0.997, 1.008) | (0.675, 0.680) | (0.654, 0.656) | (1.030, 1.038) | |
Inpatient admissions | 0.065 | 0.0769 | 0.844 | 0.065 | 0.0701 | 0.926 |
(0.064, 0.066) | (0.0764, 0.0773) | (0.830, 0.857) | (0.064, 0.066) | (0.0697, 0.0705) | (0.915, 0.937) | |
Prescription claims | 4.981 | 7.505 | 0.664 | 5.096 | 6.125 | 0.832 |
(4.962, 5.000) | (7.494, 7.516) | (0.661, 0.666) | (5.086, 5.105) | (6.115, 6.134) | (0.830, 0.834) | |
Utilization, per year – No. (%) | ||||||
Children with 1 + ED visits | 197,429 (35.39) | 1,245,724 (35.29) | 1.003 (0.999,1.007) | 157,270 (35.53) | 152,322 (34.42) | 1.032 (1.027,1.038) |
Children with 1 + inpatient admissions | 23,299 (4.18) | 172,777 (4.89) | 0.853 (0.842,0.865) | 18,884 (4.27) | 18,667 (4.22) | 1.012 (0.963,1.032) |
Quality, per year – No. (%) | ||||||
3–6 year old with well-child visit | 81,420 (59.71) | 527,383 (61.02) | 0.979 (0.974,0.983) | 63,956 (59.51) | 70,506 (65.61) | 0.907 (0.901,0.913) |
12–17 year old with well-child visit | 67,243 (48.53) | 434,738 (49.32) | 0.984 (0.978,0.990) | 53,431 (48.14) | 58,490 (52.70) | 0.914 (0.906,0.921) |
Children with ambulatory care sensitive ED visits | 100,391 (17.99) | 572,228 (16.21) | 1.110 (1.103,1.117) | 79,546 (17.98) | 71,149 (16.08) | 1.118 (1.108,1.128) |
Children with ambulatory care sensitive hospitalizations | 707 (0.1267) | 5,128 (0.1453) | 0.872 (0.806,0.944) | 560 (0.13) | 608 (0.14) | 0.921 (0.822,1.033) |
Cost, $ per year – mean (95% CI) | ||||||
Total | 2,644.49 | 3,808.78 | 0.694 | 2,716.08 | 2,955.23 | 0.919 |
(2634.19, 2654.84) | (3,802.87, 3,814.69) | (0.691, 0.697) | (2,711.17, 2,720.99) | (2,949.90, 2,960.58) | (0.917, 0.921) | |
Primary care | 794.65 | 574.75 | 1.383 | 791.03 | 545.10 | 1.451 |
(792.37, 796.93) | (574.09, 575.40) | (1.378, 1.387) | (789.97, 792.10) | (544.37, 545.84) | (1.448, 1.454) | |
Non-primary care outpatient | 869.52 | 1,576.03 | 0.552 | 902.62 | 1,199.34 | 0.753 |
(864.15, 874.93) | (1,572.15, 1,579.92) | (0.548, 0.555) | (899.80, 905.48) | (1,195.60, 1,203.09) | (0.749, 0.756) | |
ED | 173.92 | 184.06 | 0.945 | 174.88 | 175.20 | 0.998 |
(172.97, 174.88) | (183.66, 184.46) | (0.939, 0.951) | (174.39, 175.36) | (174.72, 175.69) | (0.994, 1.002) | |
Inpatient | 445.33 | 735.60 | 0.605 | 465.36 | 516.58 | 0.901 |
(442.09, 448.60) | (733.37, 737.74) | (0.601,0.610) | (463.67, 467.06) | (514.70, 518.47) | (0.896, 0.906) | |
Pharmacy | 366.43 | 743.69 | 0.493 | 387.56 | 524.38 | 0.739 |
(364.62, 368.24) | (742.24, 745.16) | (0.490, 0.495) | (386.60, 388.52) | (523.08, 525.68) | (0.737, 0.742) |