Impact of Infant Feeding Method on Health Services Costs and Utilization in a211 Medicaid Population. Abstract and Executive Summary of Dissertation

摘要

This study examines the relationship between infant feeding method (breast or211u001eformula feeding) and health care costs and utilization among 1,374 infants 211u001eenrolled in Medicaid in the state of Colorado. Data sources included Medicaid for 211u001ethe first 12 months of infants' lives linked to Vital Statistics and WIC files. 211u001eThe infant feeding-health status relationship is confounded by several factors 211u001erelated both to the choice of feeding method and to infant health outcomes, 211u001eincluding maternal income, education, age, marital status, and smoking status, 211u001eeven among this population of relatively homogeneous socioeconomic status. 211u001eMultivariate analysis of outpatient costs and utilization initially indicated 211u001ethat breastfeeding led to lower costs and utilization even after controlling for 211u001esociodemographic factors. However, after identification and removal of infants 211u001ewith pre-existing illness (illness present at birth) from the data set, the 211u001eimpact of breastfeeding on health care costs and utilization disappeared. Among 211u001einfants with pre-existing illness, those with more severe conditions were more 211u001elikely to be formula fed, despite the fact that their pre-existing illness did 211u001enot contraindicate breastfeeding. Thus, analysis with the entire study population 211u001efalsely attributes increased costs and utilization among formula feeding infant 211u001eto their feeding status.