EPSDT impact on health status.

Early and Periodic Screening, Diagnosis and Treatment (EPSDT), a large-scale operational screening program which has generated a tremendous volume of data on the sociodemographic characteristics and health status of Medicaid-eligible children, seems to provide an ideal context within which to evaluate the effectiveness of preventive child health care. Concerns about health care expenditures generally, and the effectiveness of preventive child health services specifically, lead to the question of whether the impact on the health status of the children served can be measured without significantly adding to the cost of these services with primary data collection. We employed a quasi-experimental research design using administratively-generated data from an operational EPSDT program to estimate program impact on the prevalence of serious abnormalities among the children served. We found that, compared either to themselves across time or to a control group, a representative sample of 1831 children had almost 30 percent fewer abnormalities requiring care on rescreening. The ability to demonstrate the impact of EPSDT using these data suggests, among other things relevant to policy, that a national EPSDT monitoring system could be developed that would be cost-effective and could lead to program improvement.