Identification, Treatment and Referral of Health Care Needs among MedicaidChildren during EPSDT Screening Visits, 1989

摘要

In the screening visit files each State documented wheather there were any healthcare needs discovered in the course of the screening. Although generally identified by major body system, the delineation of body systems or problem areas are not uniform across States. Twenty-two potential problem areas were established and the four State screening file data were mapped into the uniform categories. To verify the data from the EPSDT screening file, as well as to compare the results for Medicaid children to other children in the U.S., the 1991 National Ambulatory Medical Care Survey, a visit based survey, was analyzed for reason for visit, diagnoses of identified conditions and source of payment. The State data show GA and MI having very different results from CA and TN, with GA and MI having 77 percent and 85 percent of the screening visits having at least one health care need treated or referred. In CA and TN the treatment of referral rate was 29 percent and 23 percent respectively, the difference largely due to the oral health needs. Fifty percent of GA screening visits and 63 percent of MI screening visits treated oral problems or referred them for dental care; in CA and TN only 2 percent and 13 percent, respectively were treated or referred. The extremely low referral and treatment rate for dental services in CA is partly explained by the severe shortage of dental providers participating in the Medicaid program.