Early and Periodic Screening, Diagnosis, and Treatment and Infant Health Outcomes in Medicaid-Insured Infants in South Carolina

Abstract

To test the hypothesis that infants experiencing the recommended number of early and periodic screening, diagnosis, and treatment (EPSDT) visits have better health outcomes than infants with fewer visits. Data represent all health encounters for Medicaid-insured infants of mothers aged at least 18 years in South Carolina, from 2000 to 2002, who were continuously enrolled in fee-for-service insurance (n = 36,662). We examined associations between having at least the recommended number of visits in the first year and health care use in the second year: sick infant doctor visits, emergency department (ED) visits, hospital admissions, and hospitalizations and ED visits for ambulatory care sensitive conditions. Infants with at least the recommended number of EPSDT visits had a higher adjusted rate of sick infant doctor visits (rate ratio, 1.49; 95% CI, 1.41-1.58), but a lower adjusted rate of ED visits for ambulatory care sensitive conditions (rate ratio, 0.94; 95% CI, 0.89-0.99). Having at least the recommended preventive visits did not affect rates of general ED visits or of hospitalizations. Having at least the recommended number of EPSDT visits may shift some health provision from the ED to physicians' offices.