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PEDIATRICS Vol. 104 No. 5 Supplement November 1999, pp. 1192-1197

The Influence of Having an Assigned Medicaid Primary Care Physician on Utilization of Otitis Media-related Services

Received Apr 12, 1999; accepted Aug 3, 1999.

Stephen Berman*, Jessica BondyDagger , Dennis LezotteDagger , Barbara Stone§, and Patricia J. Byrns

From the Departments of * Pediatrics, Dagger  Preventive Medicine and Biometrics, and § Denver Health and Hospitals, University of Colorado Health Sciences Center, Denver, Colorado.

Objective.  This study documents the influence of having an assigned Medicaid primary care physician (PCP) on the utilization of otitis media-related services.

Design/Methods.  This is a retrospective study using the 1991 Colorado Medicaid administrative database that followed 28 844 children <13 years who had at least 1 visit for otitis media.

Results.  Children continuously enrolled in Medicaid throughout the entire year were >4 times (odds ratio: 4.2 and 4.89, respectively) as likely to always or sometimes have a PCP compared with children who were discontinuously enrolled. The likelihood of ever using the emergency department for an otitis media-related visit was increased by 26% and 50%, respectively, when a child sometimes or never had a PCP compared with always having a PCP. The likelihood of ever filling an antibiotic for otitis media was reduced by 23% and 34%, respectively, when a child sometimes or never had a PCP compared with always having a PCP. The likelihood of ever having otitis media-related surgery was not affected by PCP status, but young children, 13 to 18 months of age, had higher referral rates when they had an assigned PCP.

Conclusions.  These findings suggest that having an assigned Medicaid PCP influences the utilization patterns of some otitis media-related medical services.  Key words:  Medicaid PCP, utilization, otitis media-related services.


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