Predictors of prenatal and postpartum care adequacy in a medicaid managed care population
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Authors
Weir, Sharada G.Posner, Heather
Zhang, Jianying
Willis, Georgianna
Baxter, Jeffrey D.
Clark, Robin E.
UMass Chan Affiliations
Clinical and Population Health ResearchCenter for Health Policy and Research
Department of Family Medicine and Community Health
Document Type
Journal ArticlePublication Date
2011-07-01Keywords
AdolescentAdult
Disabled Persons
Female
Humans
Logistic Models
Managed Care Programs
Massachusetts
*Medicaid
Middle Aged
Postnatal Care
*Poverty
Pregnancy
*Pregnancy Complications
Prenatal Care
Substance-Related Disorders
United States
Young Adult
Community Health and Preventive Medicine
Preventive Medicine
Primary Care
Metadata
Show full item recordAbstract
PURPOSE: To examine factors affecting prenatal and postpartum care for an insured, but vulnerable, population. METHODS: Individual-level data on three measures of care adequacy were obtained for Massachusetts Medicaid Managed Care women who met the National Committee on Quality Assurance's Healthcare Effectiveness Data and Information Set denominator criteria for the prenatal and postpartum care measures in 2007 (n = 1,882). We modeled individual compliance with each measure separately as a binomial logistic function with individual and neighborhood characteristics, provider type, and health plan as explanatory variables. FINDINGS: In our sample, 85% of women initiated care in the first trimester, but only 62% met the goal of receiving more than 80% of the recommended number of prenatal visits. Just 60% had a timely postpartum care visit. Having a diagnosis of substance abuse or dependence reduced the odds of meeting all measures. Women with disabilities were less likely to attain two of the three measures of adequate care, as were women with other children in the household. Women who enrolled in Medicaid in the first trimester were more likely to receive the recommended number of prenatal visits than those who were enrolled before pregnancy. CONCLUSION: Given the importance of prenatal and postpartum care for maternal and child health and the recent national declining trend in timely care, initiatives to improve rates of timely and adequate care are crucial and must include components tailored toward particularly vulnerable subpopulations. All rights reserved.Source
Womens Health Issues. 2011 Jul-Aug;21(4):277-85. Epub 2011 May 12. Link to article on publisher's siteDOI
10.1016/j.whi.2011.03.001Permanent Link to this Item
http://hdl.handle.net/20.500.14038/30898PubMed ID
21565526Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.whi.2011.03.001