The influence of having an assigned medicaid primary care physician on utilization of otitis media-related services

Objective. This study documents the influence of having an assigned Medicai d primary care physician (PCP) on the utilization of otitis media-related s ervices. Design/Methods. This is a retrospective study using the 1991 Colorado Medic aid administrative database that followed 28 844 children <13 years who had at least 1 visit for otitis media. Results. Children continuously enrolled in Medicaid throughout the entire y ear were >4 times (odds ratio: 4.2 and 4.89, respectively) as likely to alw ays or sometimes have a PCP compared with children who were discontinuously enrolled. The likelihood of ever using the emergency department for an oti tis media-related visit was increased by 26% and 50%, respectively, when a child sometimes or never had a PCP compared with always having a PCP. The l ikelihood of ever filling an antibiotic for otitis media was reduced by 23% and 34%, respectively, when a child sometimes or never had a PCP compared with always having a PCP. The likelihood of ever having otitis media-relate d surgery was not affected by PCP status, but young children, 13 to 18 mont hs of age, had higher referral rates when they had an assigned PCP. Conclusions. These findings suggest that having an assigned Medicaid PCP in fluences the utilization patterns of some otitis media-related medical serv ices.