Rural populations and early periodic screening, diagnosis, and treatment services: Challenges and opportunities for local public health departments

N.L. Hale, M. Smith, J. Hardin and A. Brock-Martin

American Journal of Public Health, 2015, vol. 105, S330-S336

Abstract: Objectives: We examined geographic differences in Early Periodic Screening, Diagnosis, and Treatment (EPSDT) visits as the South Carolina Department of Health and Environmental Control (SCDHEC) transitioned from direct service provision (DSP) to assuring delivery within the larger health care system. Methods: We examined infant cohorts with continuous Medicaid coverage and normal birth weights from 1995 to 2010. Outcome variables included any EPSDT visit and the ratio of observed to expected visits. Change in SCDHEC market share over time by residence was the primary variable of interest. We used growth curve models to examine changes in EPSDT visits by rural areas and levels of DSP over time. Results: A small proportion of the study population (10%) resided in rural counties that were more dependent on SCDHEC for DSP. The trajectory of not having visits among counties with high DSPs was steeper in rural areas (0.208; P = .001) compared with urban areas (0.145; P = .002). In counties with high DSPs, the slope of the predicted ratio in rural areas (-0.033; P

Keywords: child health care; demography; health care delivery; human; infant; mass screening; medicaid; newborn; organization and management; public health service; rural population; statistics and numerical data; United States, Child Health Services; Health Services Accessibility; Humans; Infant; Infant, Newborn; Mass Screening; Medicaid; Public Health Administration; Public Health Practice; Residence Characteristics; Rural Population; South Carolina; United States (search for similar items in EconPapers)
Date: 2015
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2014.302449_5

DOI: 10.2105/AJPH.2014.302449

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