Table 3.
Healthcare utilization and quality of care during the two-year outcome period for children with medical complexity with primary care versus specialist predominant specialty seen, unweighted and inverse probability treatment weighted.
| Total | Primary Care | Specialty | Standardized difference1 | Primary Care | Specialty | Standardized difference1 | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
| ||||||||||||
| N / Mean | % / StD | N / Mean | % / StD | N / Mean | % / StD | N / Mean | % / StD | N / Mean | % / StD | |||
| N | 67,218 | 50,5 84 | 75.25% | 16,634 | 24.75% | |||||||
| Number of ambulatory care visits | 13.44 | 14.16 | 12.76 | 12.09 | 15.49 | 18.98 | −0.172 | 12.98 | 14.24 | 14.87 | 37.00 | −0.067 |
| # visits with primary care | 6.91 | 7.18 | 7.84 | 7.45 | 4.07 | 5.37 | 0.581 | 7.85 | 8.65 | 3.94 | 10.51 | 0.406 |
| # visits with pediatric primary care | 4.98 | 5.91 | 5.68 | 6.15 | 2.84 | 4.48 | 0.529 | 5.69 | 7.14 | 2.75 | 8.81 | 0.367 |
| # visits with non-pediatric primary care | 1.93 | 4.68 | 2.16 | 5.12 | 1.23 | 2.85 | 0.223 | 2.16 | 5.91 | 1.19 | 5.60 | 0.168 |
| # visits with a specialist | 6.53 | 11.43 | 4.92 | 8.03 | 11.42 | 17.31 | −0.482 | 5.13 | 9.52 | 10.93 | 33.87 | −0.233 |
| # visits with medical specialist | 4.56 | 10.07 | 3.21 | 6.48 | 8.67 | 16.11 | −0.444 | 3.35 | 7.66 | 8.32 | 31.58 | −0.217 |
| # visits with surgical specialist | 1.05 | 2.33 | 0.98 | 2.13 | 1.28 | 2.86 | −0.122 | 1.02 | 2.52 | 1.16 | 5.53 | −0.033 |
| # visits with multi-specialty clinic | 0.92 | 3.5 3 | 0.74 | 3.1 8 | 1.47 | 4.3 9 | −0.193 | 0.76 | 3.7 8 | 1.44 | 8.6 8 | −0.101 |
| Number of unique providers of care | 4.91 | 3.80 | 4.91 | 3.80 | 4.94 | 3.82 | 0.008 | 5.00 | 4.50 | 4.67 | 7.30 | 0.054 |
| Continuity of care (COC)2 | ||||||||||||
| Adequate Continuity (n/% COC > 0.5) | 15,082 | 22.44% | 11,402 | 22.54% | 3,680 | 22.12% | 0.010 | 14779 | 21.97% | 16227 | 24.16% | −0.052 |
| Primary Care | 25,770 | 38.34% | 20,633 | 40.79% | 5,137 | 30.88% | 0.208 | 27337 | 40.65% | 206 28 | 30.71% | 0.209 |
| Specialists | 21,066 | 31.34% | 14,846 | 29.35% | 6,220 | 37.39% | −0.171 | 19927 | 29.63% | 25281 | 37.64% | −0.170 |
| COC (0–1 scale) | 0.353 | 0.299 | 0.353 | 0.300 | 0.352 | 0.293 | 0.005 | 0.348 | 0.344 | 0.369 | 0.601 | −0.042 |
| Primary Care COC | 0.522 | 0.366 | 0.521 | 0.359 | 0.522 | 0.394 | −0.002 | 0.520 | 0.414 | 0.526 | 0.786 | −0.010 |
| Specialists COC | 0.496 | 0.378 | 0.501 | 0.391 | 0.486 | 0.342 | 0.040 | 0.492 | 0.452 | 0.508 | 0.688 | −0.028 |
| Received a vaccine | 45,739 | 68.05% | 34,797 | 68.79% | 10,942 | 65.78% | 0.064 | 46175 | 68.65% | 44569 | 66.35% | 0.049 |
| Adequate well child visits3 | 47,057 | 70.01% | 36,081 | 71.33% | 10,976 | 65.99% | 0.115 | 47718 | 70.95% | 45229 | 67.34% | 0.078 |
| Any ED visits not resulting in hospitalization Acute care hospitalizations | 32,833 | 48.85% | 24,961 | 49.35% | 7,872 | 47.32% | 0.040 | 33003 | 49.07% | 32750 | 48.76% | 0.006 |
| Any | 6,60 5 | 9.8 3% | 4,53 0 | 8.9 6% | 2,07 5 | 12.47% | −0.114 | 6362 | 9.4 6% | 753 2 | 11.20% | −0.057 |
| Elective | 1,718 | 2.56% | 1,081 | 2.14% | 637 | 3.83% | −0.100 | 1562 | 2.32% | 2191 | 3.26% | −0.057 |
| Non-elective | 5,545 | 8.25% | 3,862 | 7.63% | 1,683 | 10.12% | −0.087 | 5419 | 8.06% | 6150 | 9.16% | −0.039 |
1
Statistically significant differences based on standardized differences <−0.1 or >0.1 are shown in bold.
2
Limited to those with >4 ambulatory care visits during the outcome period (n=65,424for overall, 59,458for Primary Care, 51,987for specialist).
3
Receipt of adequate well-child care defined as >2 well-child visits in 24 months for CMC with 24 months of enrollment, and >1 well-child visits in CMC with <24 months of enrollment.