328 W. Claiborne St.
P.O. Box 964
Monroeville, Alabama 36460
(251) 575-4203
     
Health Policy & Advocacy
Resources
Basic InformationMore InformationLatest News
What to Do If Someone's Bleeding BadlyAre Good Kidneys Going to Waste?U.S. Gun Sales Rose After Sandy Hook Massacre: StudyCreating Your Family Health TreeLocal Smoke-Free Laws Tied to Fewer Lung Cancer CasesYour Doc Is Away? Substitute Doctors a Safe Option, Study FindsChecking Prices for Medical Procedures Online? Good LuckPatients More Prone to Complain About Younger DoctorsPatients Often Uncomfortable With Overlapping SurgeriesClinician Denial of Patient Requests Impacts SatisfactionPatients React Poorly When Docs Say 'No'Memo to Doctors: Spit Out the Bad NewsDoubts Raised About Use of Products Containing OxybenzoneReport: Industry Hid Decades-Old Study Showing Sugar's Unhealthy EffectsMany Health Care Providers Work While SickMore Patients Are Having a Say in Their Medical CareFDA Seeks to Speed Development of 'Regenerated' Organs for Medical UseHealth Care Experts in Favor of Patient Contribution to NotesMillions Could Miss Out on a Potential Alzheimer's BreakthroughU.S. May Still Benefit From Climate AccordHealth Tip: Spread Awareness of the Opioid EpidemicKnowing Too Much About Your Genes Might Be RiskyHealth Tip: Participating in a Clinical TrialMusic, Video Help Sixth-Graders Master Hands-Only CPRIncreases in U.S. Health Spending Tied to Health Service PriceHealth Tip: Prevent Germs at the Doctor's OfficeInfo Via Social Media Apps May Increase Vaccine AcceptanceIt's 'Buyer Beware' When Purchasing Medical Pot Extract OnlineGetting Self-Driving Cars on the Road Soon Might Save LivesHealth Tip: Defining Health LiteracyDoctor Burnout: A Big Health Threat in U.S.About Half of Americans Get Health Care in ERPricing Interventions Increase Sales, Intake of Healthy FoodsHealth Tip: Get to Know Your PharmacistRobots May Be Cleaning Your Hospital Room SoonCMS Launches Initiative to Examine Impact of RegulationsPatients Prefer Face-to-Face Communication, No ComputerDrop Off Your Unused Meds Saturday on 'Take Back Day'Concerns Surround Use of Direct-to-Consumer Genetic TestingMost Patients Satisfied With Relationship With PhysicianModule Developed to Improve Adult Vaccination RatesA Drug Company's Gift Might Change How Your Doctor PrescribesAlmost 4 in 10 Tanning Salons Flout State LawsDEA Taking Back Unwanted Prescription Drugs on Oct. 28Most in U.S. Don't Agree That Household Guns Up Suicide RiskCan Gun Shows Trigger Gun Violence?Tighter Rules on Arsenic in Water Saved Lives: StudyHerbal and Dietary Supplements Are Commonly Mislabeled3 Million Americans Say They Carry Handguns Every DayMany Dermatology Guideline Authors Get Industry Payments
Links
Related Topics

Health Insurance
Healthcare

Teens Mixed Up With the Law May Fall Through Medicaid Cracks

HealthDay News
by By Maureen Salamon
HealthDay Reporter
Updated: Oct 2nd 2017

new article illustration

MONDAY, Oct. 2, 2017 (HealthDay News) -- Teens on Medicaid who have been arrested at least once are more likely to seek costly emergency room care and less apt to receive preventive primary care, a new study suggests.

For the study, researchers reviewed medical and criminal records of nearly 90,000 U.S. youths, aged 12 to 18, on Medicaid. The investigators found those involved with the justice system also had more and longer gaps in Medicaid coverage than peers without arrest records.

"As a psychologist that works with justice-involved youth, the part that didn't surprise me is [they] don't go to the doctor as often and go to the emergency department more than non-justice-involved youth. That's what folks in the field thought to be true for a long time," said study author Matthew Aalsma. He's a professor of pediatrics and psychology at Indiana University School of Medicine.

"What surprised me was ... they're still going to the doctor for an annual visit, just at lower rates," Aalsma added.

Primary care interventions are "really important for everyone to do," Aalsma said. And teens who've been in trouble have higher rates of mental health, physical health, and drug and alcohol use disorders than their peers, the study noted -- issues that could be addressed by a doctor.

"We want to do everything we can to get them to that doctor's visit so we can limit [co-existing health conditions], improve health outcomes and reduce emergency department visits," he added.

More than 900,000 U.S. youths under age 18 were arrested in 2015, according to a commentary accompanying the study. While that number is 68 percent lower than its 1996 peak, it still represents one in every 36 children between ages 10 and 17 -- one in 26 boys, and one in 16 black youths.

Aalsma and his team sought to analyze the relationship between juvenile justice involvement and use of health care services. The term "justice-involved youth" includes a spectrum of teenagers, ranging from those arrested and sent home with a warning to those convicted of violent offenses.

The study examined data on about 88,600 teens enrolled in Medicaid in Marion County, Ind., from 2004 through 2011. About 23 percent of those youths had had a brush with the law.

Health care service use was identified using claims data for Medicaid, the publicly funded insurance program for the poor.

Teens outside the criminal justice system sought annual well-care health visits significantly more than teens in the legal system, the study found. Conversely, teens with a prior arrest had significantly higher annual rates of emergency department visits.

Dr. David Chen, a hospitalist with Christiana Care Hospitalist Partners in Wilmington, Del., has experience caring for kids and adults after incarceration. He praised the new study for focusing on a group typically left out of research efforts.

"What is notable," Chen said, "is the [youths'] decreased use of primary care even though they had Medicaid. It speaks to the importance of having continuity in insurance coverage as well as primary care."

Deena Chisolm is principal investigator at the Center for Innovation in Pediatric Practice at Nationwide Children's Hospital in Columbus, Ohio. Primary health care "is not just important for the health of such youth, but also for their further engagement with the justice system," she said.

"Primary care providers have the potential to identify and address [drug and alcohol] use and behavior health problems that are often the underlying cause of contact with the justice system," added Chisolm, who wrote the commentary accompanying the new research.

Chisolm said the best way to improve the health and health care of justice-involved youth is to prevent them from getting in trouble with the law in the first place.

"The important change is to provide youths with nonjudgmental, integrated care in the settings where the youths feel safe," she said. "Schools, detention facilities and community centers with co-located primary care, behavioral health and social work have the potential to address both health and risk factors for further justice involvement into adulthood."

Aalsma said one "realistic outcome" of his research would be for states to increase efforts to enroll law-involved teens in Medicaid, helping prevent health services gaps.

Other measures to help this group could include increasing their access to school-based health care, the study authors noted. School-based health centers typically offer immunizations, testing for pregnancy and sexually transmitted infections, asthma management and mental health counseling, among other services, which could lower these teens' emergency department use.

The study and accompanying editorial were released online Oct. 2 and will be published in the November print issue of the journal Pediatrics.

More information

The U.S. Department of Education offers tips for teens after incarceration.




328 W. Claiborne St.
P.O. Box 964
Monroeville,
Alabama 36460
Tel: (251)575-4203
Fax:(251)575-9459


powered by centersite dot net