Nursing Interventions to Improve EPSDT Utilization (The Healthy Kids Project).Abstract, Executive Summary, Final Report, Appendices A, B, and C

摘要

The major purpose of the Project was to conduct a randomized controlled trial totest the effectiveness and cost-effectiveness of three outreach interventions to promote use of the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program. EPSDT provides well-child screening for children on Medicaid. In rural North Carolina, the authors selected a random sample of 2,053 families with children due for an EPSDT screening and stratified them according to whether they had a home phone. Within strata, the authors randomly assigned families to receive EPSDT information by the usual (control) method of informing at Medicaid intake only; or enhanced informing by a home visit, a mailed pamphlet and letter, or (for families with phones) a phone call. All interventions produced more screenings than the control method, but increases were significant only for families with phones. Among families with phones, a home visit was the most effective intervention but a phone call was the most cost-effective. However, absolute rates of effectiveness were low, and incremental costs per effect were high. The study showed the need to develop new interventions, particularly for families without phones. Within the context of the Project and minority supplement, numerous substudies also were conducted.