Who Cares for Medicaid-Enrolled Children With Chronic Conditions?

ABSTRACT. Objective. To estimate generalist, pedi-atric subspecialist, and any subspecialist use by Medic-aid-enrolled children with chronic conditions and to de-termine the correlates of use. Methods. We analyzed Medicaid claims data col-lected from 1989 to 1992 from 4 states for 57 328 children and adolescents with 11 chronic conditions. We calcu-lated annual rates of generalist, subspecialist, and pedi-atric subspecialist use. We used logistic regression to determine the association of demographics, urban resi-dence, and case-mix (Adjusted Clinical Groups) with the use of relevant pediatric and any subspecialist care. Results. Most children with chronic conditions had visits to generalists (range per condition: 78%–90 % for children with Supplemental Security Income [SSI] an