ArticleMaternal and child health journal2022
Healthcare Utilization for Medicaid-Insured Children with Medical Complexity: Differences by Sociodemographic Characteristics.
Article in Maternal and child health journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 21 citations in OpenAlex.
- Preventing respiratory illness in cerebral palsy: Results of a pilot randomized controlled trial.PloS one · 2025Trial
- Experiences of family caregivers of children and youth with special health care needs in a medical home-connected virtual preparedness intervention.Families, systems & health : the journal of collaborative family healthcare · 2026Article
- Identifying Endocrinology Nurse Practitioners and Physician Associates Using Claims Data.The journal for nurse practitioners : JNP · 2026Article
- Associations of rurality, child opportunity, and distance with use of pediatric asthma specialists.The Journal of allergy and clinical immunology · 2026Article
- Children From Families Speaking Languages Other Than English or Spanish, Medical Complexity and PICU Utilization: Single-Center Retrospective Study, 2015-2022.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2026Article
- Article
- Rural-Urban Differences in Emergency Department Choice for Children With Medical Complexity, 2012-2017.Pediatric emergency care · 2025Article
- Impact of complex chronic diseases and life-limiting condition status on paediatric hospitalization: observational study.European journal of pediatrics · 2025Observational
- High-Risk Infant Developmental Outcome Is Associated with Medical Complexity and Neighborhood Opportunity.The Journal of pediatrics · 2025Article
- The Effect of COVID-19 on Health Care Utilization Among Children with Medical Complexity: Retrospective Chart Review Study.JMIR pediatrics and parenting · 2025Article
- Tools for Improving Access to Subspecialty Care Among Rural Children.Pediatric clinics of North America · 2025Review
- Differences in COVID-19 testing perceptions among caregivers of children with medical complexity by rurality.PloS one · 2025Article
- Factors Associated with Insured Children's Use of Physician Visits, Dentist Visits, Hospital Care, and Prescribed Medications in the United States: An Application of Behavioral Model of Health-Services Use.International journal of environmental research and public health · 2024Article
- Rural-urban disparities in health care delivery for children with medical complexity and moderating effects of payer, disability, and community poverty.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2024Article
- Telehealth for Children With Medical Complexity During the COVID Pandemic: A Qualitative Study Exploring Caregiver Experiences.Clinical pediatrics · 2024Article
- Medicaid‑Insured Children with Medical Complexity in a Rural State.Academic pediatricsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo compare differences in healthcare utilization and costs for Medicaid-insured children with medical complexity (CMC) by race/ethnicity and rurality.
methodsRetrospective cohort of North Carolina (NC) Medicaid claims for children 3-20 years old with 3 years continuous Medicaid coverage (10/1/2015-9/30/2018). Exposures were medical complexity, race/ethnicity, and rurality. Three medical complexity levels were: without chronic disease, non-complex chronic disease, and complex chronic disease; the latter were defined as CMC. Race/ethnicity was self-reported in claims; we defined rurality by home residence ZIP codes. Utilization and costs were summarized for 1 year (10/1/2018-9/30/2019) by complexity level classification and categorized as acute care (hospitalization, emergency [ED]), outpatient care (primary, specialty, allied health), and pharmacy. Per-complexity group utilization rates (per 1000 person-years) by race/ethnicity and rurality were compared using adjusted rate ratios (ARR).
resultsAmong 859,166 Medicaid-insured children, 118,210 (13.8%) were CMC. Among CMC, 36% were categorized as Black non-Hispanic, 42.7% White non-Hispanic, 14.3% Hispanic, and 35% rural. Compared to White non-Hispanic CMC, Black non-Hispanic CMC had higher hospitalization (ARR = 1.12; confidence interval, CI 1.08-1.17) and ED visit (ARR = 1.17; CI 1.16-1.19) rates; Hispanic CMC had lower ED visit (ARR = 0.77; CI 0.75-0.78) and hospitalization rates (ARR = 0.79; CI 0.73-0.84). Black non-Hispanic and Hispanic CMC had lower outpatient visit rates than White non-Hispanic CMC. Rural CMC had higher ED (ARR = 1.13; CI 1.11-1.15) and lower primary care utilization rates (ARR = 0.87; CI 0.86-0.88) than urban CMC. DISCUSSION: Healthcare utilization varied by race/ethnicity and rurality for Medicaid-insured CMC. Further studies should investigate mechanisms for these variations and expand higher value, equitable care delivery for CMC.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.