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. 2021 Apr;14(2):101016.
doi: 10.1016/j.dhjo.2020.101016. Epub 2020 Nov 6.

Predictors of Receipt of Clinical Preventive Services in Adolescents and Adults with Down Syndrome Accessing Medicaid

Kristin M Jensen  1 , Elizabeth J Campagna  2 , Elizabeth Juarez-Colunga  3 , Desmond K Runyan  4 , Allan V Prochazka  5
Affiliations

Predictors of Receipt of Clinical Preventive Services in Adolescents and Adults with Down Syndrome Accessing Medicaid

Kristin M Jensen et al. Disabil Health J. 2021 Apr.

Abstract

Background: Persons with Down syndrome (DS) require preventive care that addresses their age-/gender- and syndrome-specific needs. Yet, adolescents and adults with DS do not receive these preventive care services as recommended.

Objective/hypothesis: To identify factors that predict receipt of age-/gender- and syndrome-specific preventive healthcare among adolescents and adults with DS. We hypothesized that more healthcare encounters and greater medical complexity would increase receipt of preventive care due to more opportunities to complete these activities.

Methods: Using Medicaid claims (2006-2010) for California, Colorado, Michigan, and Pennsylvania, we conducted a retrospective cohort study of adolescents and adults with DS (≥12 years old). We modeled receipt of both ≥1 wellness examination and ≥1 thyroid function test (TFT) in 2009-2010 as a function of receipt of those same healthcare activities in 2006-08, adjusting for demographics, key comorbidities, and medical complexity using multivariable logistic regression.

Results: In this cohort of 3487 adolescents and adults with DS accessing Medicaid, 17% received both ≥1 wellness examination and ≥1 TFT in 2006-2008, 15% in 2009-2010, and only 7% during both time periods. Despite medical complexity and frequent healthcare interactions, the best predictor of future receipt of these activities was past receipt. State of residence variably impacted receipt of these preventive activities.

Conclusions: Although past receipt of wellness examination and TFT was the best predictor of future receipt of these activities, overall rates were quite low in this cohort of adolescents and adults with DS. Further work is needed to improve preventive healthcare delivery to this vulnerable population.

Keywords: Adolescents; Adults; Down syndrome; Prevention; Primary care.

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Conflict of interest statement

Conflict of Interest Statement

All authors listed have contributed sufficiently to the project to be included as authors, and all those who are qualified to be authors are listed in the author byline. Each author listed in this manuscript has seen and approved the submission of this version of the manuscript and takes full responsibility for the manuscript. To the best of our knowledge, no conflicts of interest, financial or otherwise, exist.

Figures

Figure 1 –
Figure 1 –
Receipt of Wellness Examination and Thyroid Function Test by Time Period TFT = Thyroid Function Testing
Figure 2 –
Figure 2 –
Odds of Receiving a Wellness Examination and Thyroid Function Test in 2009–2010
Figure 3 –
Figure 3 –
Subgroup Analysis Excluding of California Data: Odds of Receiving Wellness Examination and Thyroid Function Testing in 2009–2010 * Domain becomes significant with exclusion of California data. No domains lost significance with exclusion of California data.
See this image and copyright information in PMC

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References

    1. Parker SE, Mai CT, Canfield MA, Rickard R, Wang Y, Meyer RE, Anderson P, Mason CA, Collins JS, Kirby RS, Correa A. Updated National Birth Prevalence estimates for selected birth defects in the United States, 2004–2006. Birth defects research Part A, Clinical and molecular teratology. 2010;88(12):1008–16. Epub 2010/09/30. doi: 10.1002/bdra.20735. - DOI - PubMed
    1. World Health Organization. Genes and Human Disease 2012. [April 9, 2012]. Available from: http://www.who.int/genomics/public/geneticdiseases/en/print.html.
    1. Centers for Disease Control and Prevention. Data and Statistics: Occurence of Down Syndrome [updated October 21, 2014 October 12, 2015]. Available from: http://www.cdc.gov/ncbddd/birthdefects/downsyndrome/data.html.
    1. Presson AP, Partyka G, Jensen KM, Devine OJ, Rasmussen SA, McCabe LL, McCabe ER. Current Estimate of Down Syndrome Population Prevalence in the United States. J Pediatr. 2013. Epub 2013/07/28. doi: 10.1016/j.jpeds.2013.06.013. - DOI - PMC - PubMed
    1. Bittles AH, Bower C, Hussain R, Glasson EJ. The four ages of Down syndrome. Eur J Public Health. 2007;17(2):221–5. Epub 2006/07/22. doi: 10.1093/eurpub/ckl103. - DOI - PubMed

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