Table 5 Utilization, quality of care, and cost among children enrolled in fee-for-service Medicaid by primary care setting in the United States, 2012

Utilization, per year – mean (95% CI)

 Primary care visits

4.569

4.879

0.937

4.576

4.614

0.992

(4.559, 4.579)

(4.875, 4.883)

(0.934, 0.939)

(4.569,4.582)

(4.610,4.618)

(0.990, 0.993)

 Non-primary care outpatient visits

5.866

9.790

0.599

6.1367

7.426

0.826

(5.829, 5.903)

(9.766, 9.815)

(0.595, 0.603)

(6.118, 6.154)

(7.405, 7.447)

(0.823, 0.830)

 ED visits

0.677

0.675

1.002

0.677

0.655

1.034

(0.674, 0.680)

(0.674, 0.677)

(0.997, 1.008)

(0.675, 0.680)

(0.654, 0.656)

(1.030, 1.038)

 Inpatient admissions

0.065

0.0769

0.844

0.065

0.0701

0.926

(0.064, 0.066)

(0.0764, 0.0773)

(0.830, 0.857)

(0.064, 0.066)

(0.0697, 0.0705)

(0.915, 0.937)

 Prescription claims

4.981

7.505

0.664

5.096

6.125

0.832

(4.962, 5.000)

(7.494, 7.516)

(0.661, 0.666)

(5.086, 5.105)

(6.115, 6.134)

(0.830, 0.834)

Utilization, per year – No. (%)

 Children with 1 + ED visits

197,429 (35.39)

1,245,724 (35.29)

1.003 (0.999,1.007)

157,270 (35.53)

152,322 (34.42)

1.032

(1.027,1.038)

 Children with 1 + inpatient

admissions

23,299 (4.18)

172,777 (4.89)

0.853 (0.842,0.865)

18,884 (4.27)

18,667 (4.22)

1.012

(0.963,1.032)

Quality, per year – No. (%)

 3–6 year old with well-child visit

81,420 (59.71)

527,383 (61.02)

0.979

(0.974,0.983)

63,956 (59.51)

70,506 (65.61)

0.907

(0.901,0.913)

 12–17 year old with well-child visit

67,243 (48.53)

434,738 (49.32)

0.984

(0.978,0.990)

53,431 (48.14)

58,490 (52.70)

0.914

(0.906,0.921)

 Children with ambulatory care sensitive ED visits

100,391 (17.99)

572,228 (16.21)

1.110

(1.103,1.117)

79,546 (17.98)

71,149 (16.08)

1.118

(1.108,1.128)

 Children with ambulatory care sensitive hospitalizations

707 (0.1267)

5,128 (0.1453)

0.872 (0.806,0.944)

560 (0.13)

608 (0.14)

0.921

(0.822,1.033)

Cost, $ per year – mean (95% CI)

 Total

2,644.49

3,808.78

0.694

2,716.08

2,955.23

0.919

(2634.19, 2654.84)

(3,802.87, 3,814.69)

(0.691, 0.697)

(2,711.17, 2,720.99)

(2,949.90, 2,960.58)

(0.917, 0.921)

 Primary care

794.65

574.75

1.383

791.03

545.10

1.451

(792.37, 796.93)

(574.09, 575.40)

(1.378, 1.387)

(789.97, 792.10)

(544.37, 545.84)

(1.448, 1.454)

 Non-primary care outpatient

869.52

1,576.03

0.552

902.62

1,199.34

0.753

(864.15, 874.93)

(1,572.15, 1,579.92)

(0.548, 0.555)

(899.80, 905.48)

(1,195.60, 1,203.09)

(0.749, 0.756)

 ED

173.92

184.06

0.945

174.88

175.20

0.998

(172.97, 174.88)

(183.66, 184.46)

(0.939, 0.951)

(174.39, 175.36)

(174.72, 175.69)

(0.994, 1.002)

 Inpatient

445.33

735.60

0.605

465.36

516.58

0.901

(442.09, 448.60)

(733.37, 737.74)

(0.601,0.610)

(463.67, 467.06)

(514.70, 518.47)

(0.896, 0.906)

 Pharmacy

366.43

743.69

0.493

387.56

524.38

0.739

(364.62, 368.24)

(742.24, 745.16)

(0.490, 0.495)

(386.60, 388.52)

(523.08, 525.68)

(0.737, 0.742)