Obesity Prevalent in Medicaid Kids
Children on Medicaid are six times more likely to be treated for obesity than children with private insurance are, according to a study from Thomson Medstat, a consulting/research firm based in Ann Arbor, Mich. The study looked at 2004 data from eight state Medicaid programs that represented 1 million children. The information was compared with records from 62 large insurers that insured another 1.9 million children. The study found that 195 of every 100,000 privately insured children were treated for obesity, compared with 1,115 per 100,000 for Medicaid children. Researchers speculated that the nearly sixfold difference “underestimates the differential in untreated obesity,” given the difficulties that children covered by Medicaid have with accessing the health care system. Dr. William Cochran, a pediatric gastroenterologist at Geisinger Health System in Danville, Pa., said that the findings were “interesting, but I do not think that this is of any tremendous significance.” It's already known that pediatric obesity is being underdiagnosed and undertreated by health care providers. Because obesity is not a diagnosis covered by most insurance companies, many providers do not code it, he said. Although lower socioeconomic status may factor in as a risk, along with obese parents and minority status, “obesity is very prevalent throughout our society at all socioeconomic levels. With 15% of children being overweight and 15% being obese, all children should be considered at risk,” he said.
AAP, Microsoft Seek Internet Controls
The American Academy of Pediatrics is working with Microsoft to develop a new line of parental controls for the Internet. The free program, called Family Safety Settings, will be part of Microsoft's Windows Live platform and will start rolling out early this summer. The program will allow families to customize controls for each family member. When children go online, “the No. 1 threat is predators,” Dr. Donald Shifrin, chair of the AAP's Committee on Communications, said in an interview on the AAP Web site. “Beyond that, we also know they can become immersed in online gaming, gambling, and cyberbullying on blog sites. There also are sites on obesity, alcohol, tobacco, and body image that can pose potential problems.” Ryan Hamlin, general manager of Microsoft's technology care and safety group, noted that one feature in the program will warn users before they enter a site that has been deemed inappropriate and will log the activity if the user chooses to proceed to the site—“a tool to help parents understand how their children may be using the Internet.”
Medicaid Prodded on Mental Health
Congress should not give Medicaid too much flexibility when it comes to providing services for children with emotional and substance use disorders, according to a new report from the National Association of Psychiatric Health Systems and the National Association for Children's Behavioral Health. These children “are one of the most at-risk populations served by the Medicaid program—and one of the populations that can benefit most from early and appropriate behavioral health care interventions,” the associations said in the report, titled “Medicaid: Principles for Treatment of Children and Youth With Emotional and Substance Use Disorders.” “Without Medicaid, there is no access to or coverage of mental health care for many of our country's most vulnerable—and treatable—children and youth.” In a separate statement, the two groups urged Congress and the states to reject proposed cuts in the federal government's 2007 Medicaid budget that would affect the program's mental health budget, including the Early and Periodic Screening, Diagnosis, and Treatment program; targeted case management; rehabilitation and clinic options for treatment; and the “under 21” psychiatric benefit.
Docs' Drug-Test Methods Miss Mark
Pediatricians and other primary care physicians often don't use the right urine sampling techniques and validation procedures when they perform drug tests on adolescent patients. Dr. Sharon Levy of Harvard Medical School and her colleagues surveyed 359 physician members of the American Academy of Pediatrics, Society of Adolescent Medicine, and American Academy of Family Physicians and found that only 23% of physician respondents used an effective collection procedure (patient provides identification, empties pockets, and uses the bathroom without running water; blue dye is placed in standing water; and specimen temperature is checked immediately). Only 7% of respondents said they routinely checked both urine creatinine level and specific gravity to prevent patients from cheating on a test by providing diluted urine (Arch. Pediatr. Adolesc. Med. 2006;160:146–50).