EPSDT Care and Emergency Department Visits for Non-Urgent Care: Hispanic vs. Non-Hispanic Children in a Border Community

Abstract

Objectives: We examine the use of emergency departments for non-urgent care, comparing children who received recommended EPSDT services to those who do not, analyzing differences between Hispanic and Non-Hispanic children, controlling for differences in their characteristics. Methods: A retrospective, longitudinal study of a cohort of approximately 6,000 children during the years from 1999-2009 using data from hospital and emergency department (ED) claims, paediatric office visits and claims data from Medicaid (AHCCCS) and SCHIP. Three different versions of an econometric model are presented. The estimates also include the effects of health insurance coverage and the lack thereof by evaluating the records of all children age 0-19 in Yuma County who met any of the following criteria: insured by Medicaid or SCHIP at any time; or used the emergency department (ED) or any other participating provider during the ten years; or were immunized. We test if the provision of recommended EPSDT services by age two, affected the subsequent number of nonurgent care visits to hospital’s ED. Results: Children without continuous health insurance coverage are twice as likely as continuously insured children to use and ED for non-urgent care. Controlling for health insurance coverage and demographics, the receipt of recommended EPSDT care by age two significantly reduces non-urgent care visits to the ED for Hispanic children. In some instances the likelihood of such visits is cut in half. Conclusion: The results suggest that the provision of EPSDT services to the growing number of Hispanic children can yield significant benefits.