Prenatal and Postpartum Care Disparities in a Large Medicaid Program.
<italic>Objectives</italic> Pennsylvania’s maternal mortality, infant mortality, and preterm birth rates rank 24th, 35th, and 25th in the country, and are higher among racial and ethnic minorities. Provision of prenatal and postpartum care represents one way to improve these outcomes. We assessed th...
| Publicado en: | Maternal & Child Health Journal Vol. 22; no. 3; pp. 429 - 438 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Mar2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=128397558&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 128397558 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10927875 N9J jtl: Maternal & Child Health Journal issn: 10927875 maglogo: N pubinfo: dt: Mar2018 vid: 22 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 128397558 128397558 128397558 10.1007/s10995-017-2410-0 128397558 ppf: 429 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Prenatal and Postpartum Care Disparities in a Large Medicaid Program. aug: au: Parekh, Natasha Jarlenski, Marian Kelley, David affil: University of Pittsburgh School of Medicine, 200 Lothrop Street, Suite 933 W, 15213, Pittsburgh, PA, USA sug: subj: Prenatal Care Postnatal Care Healthcare Disparities Medicaid Human Pennsylvania Minority Groups Quality Improvement Managed Care Programs Logistic Regression Cross Sectional Studies Odds Ratio Data Analysis Software Ethnic Groups ab: <italic>Objectives</italic> Pennsylvania’s maternal mortality, infant mortality, and preterm birth rates rank 24th, 35th, and 25th in the country, and are higher among racial and ethnic minorities. Provision of prenatal and postpartum care represents one way to improve these outcomes. We assessed the extent of disparities in the provision and timeliness of prenatal and postpartum care for women enrolled in Pennsylvania Medicaid. <italic>Methods</italic> We performed a cross-sectional evaluation of representative samples of women who delivered live births from November 2011 to 2015. Our outcomes were three binary effectiveness-of-care measures: prenatal care timeliness, frequency of prenatal care, and postpartum care timeliness. Pennsylvania’s Managed Care Organizations (MCOs) were required to submit these outcomes to the state after reviewing administrative and medical records through a standardized, validated sampling process. We assessed for differences in outcomes by race, ethnicity, region, year, and MCO using logistic regression. <italic>Results</italic> We analyzed data for 12,228 women who were 49% White, 31% Black/African American, 4% Asian, and 15% Hispanic/Latina. Compared to Black/African American women, white and Asian women had higher odds of prenatal and postpartum care. Hispanic/Latina women had higher frequency of prenatal care than non-Hispanic women. Pennsylvania’s Southeast had lower prenatal care and Northwest had lower postpartum care than other regions. Prenatal care significantly decreased in 2014 and increased in 2015. We observed differences between MCOs, and as MCO performance diminished, racial disparities within each plan widened. We explored hypotheses for observed disparities in secondary analyses. <italic>Conclusions for Practice</italic> Our data demonstrate that interventions should address disparities by race, region, and MCO in equity-promoting measures. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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