This research was funded by a supplemental grant from the National Center on Birth Defects and Developmental Disabilities (NCBDDD), Centers for Disease Control and Prevention, Atlanta, Georgia (U50/CCU422096), which was supported through funding from the National Foundation for Facial Reconstruction.
Article first published online: 22 OCT 2011
Copyright © 2011 Wiley Periodicals, Inc.
Birth Defects Research Part A: Clinical and Molecular Teratology
Special Issue: 2011 Congenital Malformations Surveillance Report
Volume 91, Issue 12, pages 1019–1027, December 2011
How to Cite
Cassell, C. H., Grosse, S. D., Thorpe, P. G., Howell, E. E. and Meyer, R. E. (2011), Health care expenditures among children with and those without spina bifida enrolled in Medicaid in North Carolina. Birth Defects Research Part A: Clinical and Molecular Teratology, 91: 1019–1027. doi: 10.1002/bdra.22864
Presented at the 13th Annual Meeting of the National Birth Defects Prevention Network, March 8–10, 2010, National Harbor, Maryland.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
The authors have no financial relationships relevant to this article to disclose.
- Issue published online: 9 DEC 2011
- Article first published online: 22 OCT 2011
- Manuscript Accepted: 25 AUG 2011
- Manuscript Revised: 19 AUG 2011
- Manuscript Received: 3 MAY 2011
- spina bifida;
- birth defects
National data on health care use among children with special needs are limited and do not address children with spina bifida (SB). One recent study examined health care costs during 2003 among privately insured individuals with SB. Our objective was to compare health care use and expenditures among publicly insured children with SB to children without a major birth defect and among children with SB with and without hydrocephalus.
Data from the North Carolina Birth Defects Monitoring Program and Medicaid were linked to identify continuously enrolled children with SB (case children) and children without a major birth defect (control children) born from 1995 to 2002. Medicaid expenditures per child for medical, inpatient, outpatient, dental, well-child care, developmental/behavioral services, and home health for those aged 0 to 4 years old were calculated for case and control children and for case children with and without hydrocephalus.
Of 373 case children who survived infancy, 205 (55%) were enrolled in Medicaid. Expenditures were assessed for 144 case and 5674 control children aged 0 to 4 years old continuously enrolled in Medicaid. During infancy, mean expenditure was $33,135 per child with SB and $3900 per unaffected child. The biggest relative expenditures were for developmental/behavioral services (82 times higher for case than control child [$1401 vs. $17]) and home health services (20 times higher [$821 vs. $41]). Average expenditure for an infant with SB and hydrocephalus was 2.6 times higher than an infant with SB without hydrocephalus ($40,502 vs. $15,699).
Expenditure comparisons by SB subtype are important for targeting health care resources. Birth Defects Research (Part A), 2011. © 2011 Wiley Periodicals, Inc.