18th ANNUAL EARLY HEARING DETECTION & INTERVENTION MEETING
March 3-5, 2019 • Chicago, IL
Loss to Diagnostic Follow Up in North Carolina: A Validation Study
Introduction: In North Carolina, 99% of infants are screened for hearing loss by three months of age. Among all infants who screened positive for hearing loss between 2011 and 2014, approximately 30% of children did not have a documented audiological evaluation in the Early Hearing Detection and Intervention Information System (EHDI-IS). The odds of an infant being lost to diagnostic follow up (LTF) increased in NC over this period and was greatest among the Eastern and Southeastern regions of the state. We estimated whether cases LTF in EHDI-IS were true cases or lost to documentation. We evaluated how this association differed across regions of NC. Methods: We ascertained cases of infants LTF in EHDI-IS in 2014 and linked this cohort to the NC baby love file to determine infant Medicaid enrollment. We then linked infants enrolled in Medicaid to Medicaid claims to ascertain any diagnosis or procedure code within one year of the infant’s date of birth indicating an audiological evaluation. We considered at least one audiological billable code the “true measure” to differentiate loss to follow up versus loss to documentation. We calculated the false positive rate as the number of false positive cases/ true negative+ false positives. Results: In 2014, 779 infants screened positive for hearing loss. Among those children who failed screening, 32.7% of infants were LTF. Among cases who were LTF, 67% of infants’ mothers were receiving prenatal Medicaid. False positive rates for LTF cases for NC and by region in the state will be presented. Conclusion: Approximately one third of infants who screened positive in 2014 for hearing loss were LTF. The distribution of cases LTF were concentrated in with Northern and Southeastern regions of NC. We will present the rates of false positive cases by regions across the state.
- Participants will understand the percentage of children in NC in 2014 who were lost to diagnostic follow up and have a diagnosis or procedure code for an audiological evaluation with one year after birth in Medicaid claims.
- Participants will understand the false postive rate of loss to follow up cases in NC in 2014 among children enrolled in Medicaid
- Participants will understand how rates of false positive cases differ by regions of NC in 2014 among children enrolled in Medicaid
Poster:
This presentation has not yet been uploaded.
Presenter: Stephanie Watkins
Dr. Watkins is both a pediatric physical therapist and a neurodevelopmental epidemiologist with an interest in delivery of health services, social and environmental factors, and community interventions which influence health outcomes for women and children. She has over ten years of experience in maternal and child health working as both a pediatric physical therapist in NC schools as well a researcher on large population based studies. Dr. Watkins currently serves as both the Maternal and Child Health epidemiologist for the state of NC as well as a research scientist with the Center for Health Promotion and Disease prevention at the University of North Carolina at Chapel Hill. Her work uses methods in causal inference to estimate the effects of interventions in large population level databases.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Mr Whisler is the business analyst for the EDHI program
ASHA DISCLOSURE:
Financial -
Nonfinancial -
Dr. Fort is the Genetics and Newborn Screening Unit Manager in the Whole Child Health Section of the North Carolina Division of Child and Family Well-Being and serves as the NC EHDI Coordinator. Marcia has worked with the NC EHDI program since 2002. Dr. Fort has 32 years of experience as a pediatric audiologist in hospital, private practice, ENT office and public school settings.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.