Impact of the COVID-19 Pandemic on Pediatric Preventive Health Care Among North Carolina Children Enrolled in Medicaid
- PMID: 38146859
- PMCID: PMC10750309
- DOI: 10.1093/jpids/piad061
Impact of the COVID-19 Pandemic on Pediatric Preventive Health Care Among North Carolina Children Enrolled in Medicaid
Abstract
Background: Children enrolled in private insurance had reduced preventive health care during the coronavirus disease 2019 (COVID-19) pandemic. However, the impact of the pandemic on children enrolled in Medicaid has been minimally described.
Methods: We used an administrative claims database from North Carolina Medicaid to evaluate the rates of well-child visits and immunization administration for children ≤14 months of age, and used a quasi-Poisson regression model to estimate the rate ratio (RR) of each outcome during the pandemic period (3/15/2020 through 3/15/2021) compared with the pre-pandemic period (3/15/2019 through 3/14/2020).
Results: We included 83 442 children during the pre-pandemic period and 96 634 children during the pandemic period. During the pre-pandemic period, 405 295 well-child visits and 715 100 immunization administrations were billed; during the pandemic period, 287 285 well-child visits and 457 144 immunization administrations were billed. The rates of well-child visits (RR 0.64; 95% CI, 0.64-0.64) and vaccine administration (RR 0.55; 95% CI, 0.55-0.55) were lower during the pandemic compared with the pre-pandemic period.
Conclusions: The rates of well-child visits and immunization administrations among North Carolina children enrolled in public insurance substantially decreased during the first year of the COVID-19 pandemic.
Keywords: COVID-19; Medicaid; health equity; preventive care; vaccination; well-child visits.
© The Author(s) 2023. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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References
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- American Academy of Pediatrics Committee on Practice and Ambulatory Medicine. 2015 Recommendations for preventive pediatric health care Committee on Practice and Ambulatory Medicine and Bright Futures periodicity schedule workgroup. Pediatrics 2015; 136:e727. - PubMed
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- Centers for Disease Control and Prevention. Well-Child Visits and Recommended Vaccinations. https://www.cdc.gov/vaccines/parents/visit/vaccination-during-COVID-19.html. Accessed 17 July 2022.
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- Cooper R. Executive Order No. 121 stay at home order and strategic directions for North Carolina in response to increasing COVID-19 cases. 2020.
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- Cooper R. Executive Order No. 141 easing restrictions on travel, business operations, and mass gatherings: phase 2. 2020.
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