You have accessJournal of UrologyPediatrics: Basic Research1 Apr 2012735 ELECTIVE CIRCUMCISION IN A MEDICAID POPULATION PARENTAL, PHYSICIAN, AND REGULATORY INSIGHT Austin Lutz, Christopher Small, Kurt Eeg, and Christopher Roth Austin LutzAustin Lutz New Orleans, LA More articles by this author , Christopher SmallChristopher Small New Orleans, LA More articles by this author , Kurt EegKurt Eeg New Orleans, LA More articles by this author , and Christopher RothChristopher Roth New Orleans, LA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.820AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Louisiana (LA) Medicaid stopped coverage of neonatal circumcisions in 2005. The aim of this study was to assess the current opinions of pediatricians, parents of boys seeking circumcision, and the Department of Health and Hospitals (DHH) regarding the outcomes of this policy change. METHODS The membership of the LA chapter of the American Academy of Pediatrics (AAP) was emailed a questionnaire regarding neonatal circumcision. Parents of boys referred to the urology clinic at Children's Hospital New Orleans for evaluation for circumcision werealso administered a survey. Personal communication with the DHH allowed for an assessment of the economic outcomes of this policy change. RESULTS 166 of the 581(29%) contacted pediatricians responded to the survey of which 58% have patient populations consisting of >60% Medicaid. The strongest responses in support of neonatal circumcision were ‘cultural, religious, and personal' (p< 0.05). 87% of pediatricians were familiar with AAP policy statement regarding neonatal circumcision. 3% were provided patient education materials by the DHH regarding the policy change. 44% and 60% of pediatricians have seen an increase in post-neonatal circumcisions secondary to medical indications and parental preference respectively. 62 of 73 (85%) of parents surveyed reported Medicaid as their primary insurance. The most common reason for not being circumcised as a newborn was lack of insurance coverage (49%). 48% reported being instructed on the care of the uncircumcised phallus of whom 78% were doing so correctly. When questioned about the importance of neonatal circumcision, parents most strongly answered to prevent urinary tract or skin infection and sexually transmitted disease. 90% of respondents stated that they would pursue circumcision of their son despite being told by the pediatrician that is not medically necessary. DHH data indicate that following the policy change there was a sharp decrease in the number of both elective and medically necessary circumcisions performed; however, the annual number of medically necessary circumcisions has steadily increased since that time. Cost savings for the State to date are estimated at $2.7 million. CONCLUSIONS Subjective data from pediatricians and objective data from the DHH demonstrate an increase in medically necessary circumcisions. Most parents seeking elective circumcision do so regardless of perceived medical need. Increased educational efforts towards parents and pediatricians alike may be needed to balance the medical and economical realities of elective circumcision. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e301-e302 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Austin Lutz New Orleans, LA More articles by this author Christopher Small New Orleans, LA More articles by this author Kurt Eeg New Orleans, LA More articles by this author Christopher Roth New Orleans, LA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...