Uniform TitleAdult medicaid beneficiaries with developmental disabilities and epilepsy: profiles of service use and costs
NameKnox, Michael (author), Crystal, Stephen (chair), Huang, Chien-Chung (internal member), Prince, Jonathan (internal member), Sambamoorthi, Usha (outside member), Like, Robert (outside member), Rutgers University, Graduate School - New Brunswick,
Developmentally disabled--Services for,
DescriptionAdults with developmental disabilities -- serious chronic impairments that begin in childhood and continue through the lifespan -- are a vulnerable population whose disabilities significantly affect their lives and who typically require lifelong supports (Aday, 1993; Developmental Disabilities Assistance and Bill of Rights Act of 2000, P.L. 106-402). This research analyzed eligibility and claims files of 9,303 community-dwelling adult Medicaid beneficiaries ages 21-64 that were enrolled with the NJ Division of Developmental Disabilities. Using an adapted Behavioral Model for Vulnerable Populations (Gelberg, Andersen, &amp;amp; Leake, 2000) as a conceptual framework, the study identified characteristics associated with epilepsy and addressed the impact of epilepsy on health service use and expenditures. It also identified patterns of epilepsy-related generalist and specialist physician care and examined the association of individual characteristics and patterns of physician care with health care use and expenditures.
Adult Medicaid beneficiaries with developmental disabilities and epilepsy were more likely than those without epilepsy to have one or more developmental disability diagnoses other than epilepsy, psychiatric comorbidity, and physical comorbidity. Individuals with epilepsy were more likely than those without epilepsy to have an inpatient admission and to have an emergency room visit. Epilepsy also was associated with higher annual expenditures. Among those with epilepsy, African Americans were less likely than whites to have an epilepsy-related specialist visit. Individuals with Medicare and Medicaid coverage were much less likely to have an epilepsy-related emergency room visit than individuals with Medicaid only.
Study results can inform policy makers and practitioners in state developmental disabilities and Medicaid agencies as well as other professionals who assist people with developmental disabilities and their families in accessing medical care. Access to an appropriate health provider should be a priority of developmental disability case managers, care givers, and residential providers as well as state health care policy makers. The apparent disparity in access to epilepsy-related specialist care also underscores the need for state initiatives to ensure equitable access to care. Moreover, findings regarding comorbidities and increased hospital use by those with epilepsy suggest a need to explore approaches for better management of epilepsy, including coordination between generalist and specialist care.
NoteIncludes bibliographical references (p. 177-188).
CollectionGraduate School - New Brunswick Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.