Impact of the COVID-19 Pandemic on Pediatric Preventive Health Care Among North Carolina Children Enrolled in Medicaid.
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2023-12
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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.Type
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Publication Info
Thakkar, Pavan V, Zeni Scott, Molly Hoffman, Jesse Delarosa, Jesse Hickerson, Angelique E Boutzoukas, Daniel K Benjamin, M Alan Brookhart, et al. (2023). Impact of the COVID-19 Pandemic on Pediatric Preventive Health Care Among North Carolina Children Enrolled in Medicaid. Journal of the Pediatric Infectious Diseases Society, 12(Supplement_2). pp. S14–S19. 10.1093/jpids/piad061 Retrieved from https://hdl.handle.net/10161/33959.
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Scholars@Duke
Angelique Boutzoukas
I am a pediatric infectious disease specialist and pediatric clinical researcher. My research interests are centered around finding the optimal ways to manage infections and minimize harms to patients. Recognizing the growing global threat of antibiotic resistance, I am particularly interested in finding the right dose and duration of antibiotics that children should receive to treat their infections, and studying the epidemiology and prevention of antibiotic resistant infections.
Daniel Kelly Benjamin
Dr. Danny Benjamin is the Principal Investigator and Chair of the National Institute of Child Health and Human Development’s Pediatric Trials Network. The Network is responsible for designing and leading clinical trials of off-patent medicines in children of all ages across all therapeutic areas. The team has established, or is actively studying, the correct dosing and safety of more than 100 of the most commonly used medicines in children. These trials are conducted under an Investigational New Drug (IND) application with guidance from the Food and Drug Administration for labeling.
The Pediatric Trials Network has directly impacted the healthcare of over 90% of American children.
Signature programs of the Network include clinical trials in premature, term infants, breast feeding mothers, and obese children. Over the past 10 years, Danny’s group has enrolled more premature infants, at more sites, in more clinical trials of off-patent anti-infectives under an IND than all other academic medical centers, pharmaceutical companies, and government agencies in the world, combined.
Danny is recognized by the National Institutes of Health as a premiere mentor and educator. His research program serves as a platform to train students and early career investigators. Danny’s group has a clinical research summer program for high school, college graduate school, and medical students that recruits and mentors ~30 students each academic year. He has been the primary or secondary mentor for 10 faculty who have received career development awards and who have then gone on to establish their own independent research programs; six of whom are now Distinguished Professors.
Danny's service to the community is expressed through his passion for coaching baseball. He has coached over 1,000 recreation league, travel league, and scholastic baseball games. He is the head coach for Smith Middle School Baseball, perennially southern conference champions. Danny and his wife own a charitable non-profit that provides athletic and fitness opportunities for disadvantaged and special-needs school-aged boys and girls.
Maurice Alan Brookhart
M. Alan Brookhart, Ph.D. is a Professor in the Department of Population Health Sciences at Duke University. He is also an Adjunct Professor at UNC Chapel Hill and an Honorary Professor of Clinical Epidemiology at Aarhus University, Denmark. Alan did his doctoral training in biostatistics at UC Berkeley and was on faculty at Harvard Medical School and UNC Chapel Hill prior to joining the faculty at Duke.
Alan develops and applies epidemiologic and statistical methods for learning in real-world healthcare data. Much of his substantive work involves studies of the effects of treatments and policies in complex and vulnerable patient populations, such as those with end-stage renal disease. He has taught courses and workshops in pharmacoepidemiology, causal inference, epidemiologic methods, cluster-randomized trials, data visualization, and machine learning. He is a member of many expert panels for industry, academia, not-for-profit organizations, and government.
In addition to his academic work, Alan co-founded two start-up companies: RxAnte, Inc, which uses predictive analytics to target adherence improvement interventions to high-risk patients, and NoviSci, Inc, a healthcare data sciences company that builds tools to facilitate learning and visualization in complex, real-world data.
Areas of Expertise: epidemiology, observational study design, causal inference, predictive models, and data visualization
Kanecia Obie Zimmerman
Ganga Moorthy
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