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  1. Fulltext. Primary care case management and birth outcomes in the Iowa medicaid program.

    Article - En anglais

    Fulltext.

    Objectives

    This study compares prenatal care utilization and birth outcomes between Iowa Medicaid recipients receiving care in a primary care case management (PCCM) system and those receiving care in a fee-for-service (FFS) system.

    Methods

    Birth certificates linked with Medical hospitalization claims were analyzed for seven PCCM and seven FFS counties.

    Results

    From 1989 through 1992, there was (1) a 20% increase in the number of women who received adequate prenatal care in the FFS counties, vs a 5% increase in the PCCM counties ; (2) a 17% increase in the number of women who initiated care within the first trimester in the FFS counties, vs a 6% increase in the PCCM counties ; and (3) a 442% increase in the number of women who received enhanced prenatal services in the FFS counties, vs a 278% increase in the PCCM counties.

    There were no significant differences between groups in mean gestational age or birthweight ; however, there was an increase of very-low-birth-weight babies in both groups.

    Conclusions

    PCCM, as implemented by the Iowa Medicaid program, has not appreciably improved prenatal care utilization or birth outcomes.

    Mots-clés Pascal : Surveillance, Prénatal, Gestation, Pronostic, Naissance, Service santé, Programme sanitaire, Soin intégré, Evaluation, Femme, Homme, Nourrisson, Etude comparative, Iowa, Etats Unis, Amérique du Nord, Amérique, Politique sanitaire

    Mots-clés Pascal anglais : Surveillance, Prenatal, Pregnancy, Prognosis, Birth, Health service, Sanitary program, Managed care, Evaluation, Woman, Human, Infant, Comparative study, Iowa, United States, North America, America, Health policy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0205019

    Code Inist : 002B20F01. Création : 21/05/1997.