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- Title
Primary Care Case Management and Birth Outcomes in the Iowa Medicaid Program.
- Authors
Schulman, Elizabeth D.; Sheriff, Doris Jean; Momany, Elizabeth T.
- Abstract
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 Medicaid hospitalization claims were analyzed for seven PCCM and seven FFS counties. Result From 1989 through (992, them 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 FES counties, vs a 278% increase in the PCCM counties. There were no significant differences between groups in mean gestational age or birth weight however, there was an increase of very-low-birthweight babies in both groups. Conclusions. PCCM, as implemented by the Iowa Medicaid program, has not appreciably improved prenatal care utilization or birth outcomes.
- Subjects
IOWA; UNITED States; PRENATAL care; MEDICAID; HEALTH insurance; PRIMARY care; MATERNAL health services
- Publication
American Journal of Public Health, 1997, Vol 87, Issue 1, p80
- ISSN
0090-0036
- Publication type
Article
- DOI
10.2105/AJPH.87.1.80