Predictors of Receipt of Clinical Preventive Services in Adolescents and Adults with Down Syndrome Accessing Medicaid.
Kristin M Jensen, Elizabeth J Campagna, Elizabeth Juarez-Colunga and 2 others
PMID 33229308WHAT IT FOUND
Most adolescents and adults with Down syndrome on Medicaid did not get recommended preventive care.
Having received care previously was the strongest predictor of getting it again. Simply seeing a doctor for other issues did not lead to catching up on missed screenings.
Key findings
01Only 17% of the cohort received both a wellness examination and thyroid testing in the first three years, and only 7% received both in both time periods.
02The strongest predictor of receiving preventive care later was whether the patient had already received it earlier.
03Frequent visits for non-preventive issues (like emergencies or chronic conditions) did not predict whether patients received recommended screenings.
STILL TO COME
How it was doneWhat they found
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What it does not show
Reliance on claims data means care provided but not billed, or discussions not coded, are missed. The cohort is limited to Medicaid beneficiaries, so results may not generalize to those with private insurance. California accounted for 85% of the cohort; although a subgroup analysis excluding California showed similar trends, the geographic concentration is high. The data predates the Affordable Care Act, so current insurance landscapes may differ.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that frequent contact with the healthcare system for other issues will lead to patients receiving recommended preventive screenings. The study found that having many non-wellness visits did not predict whether patients got their annual wellness exams and thyroid tests.