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- Title
Use of perinatal and infant health services by Mexican-American Medicaid enrollees.
- Authors
Moore P; Hepworth JT; Moore, P; Hepworth, J T
- Abstract
<bold>Objectives: </bold>Lack of health insurance and a regular source of medical care are barriers affecting use of health services by Mexican Americans. We studied perinatal and infant health service use by Mexican-American women and non-Hispanic white women and their infants enrolled in Arizona's Medicaid program and explored characteristics associated with use of health services.<bold>Design: </bold>A descriptive comparative study that used data collected from office records, birth certificates, and household interviews.<bold>Setting: </bold>Participants resided in the state's most populous county and were enrolled in the Arizona Health Care Cost Containment System, a health maintenance organization-oriented Medicaid demonstration project.<bold>Subjects: </bold>Random sample of 308 Mexican-American mother-infant dyads and 312 non-Hispanic white mother-infant dyads. The women were enrolled before the sixth month of pregnancy and for 60 days post partum; their infants were continuously enrolled throughout their first year.<bold>Outcome Measures: </bold>Timing and number of prenatal visits and a modified Kessner Index, postpartum visits, number and purpose of office visits during the infants' first year, and immunizations received.<bold>Results: </bold>Mexican Americans averaged fewer prenatal visits than non-Hispanic whites (8.6 vs 10.2 visits) and were less likely to have "adequate" care (41.1% vs 52.8%). Both groups of mothers are well below the 68% of women nationally who receive adequate prenatal care. Controlling for important socioeconomic status and cultural characteristics, ethnicity had a strong independent effect on the number of prenatal visits and adequacy of prenatal care. Mexican-American infants made fewer visits (8.2 vs 9.8) and completed fewer age-appropriate immunizations than non-Hispanic whites.<bold>Conclusions: </bold>Health insurance and a regular source of care are insufficient conditions for ensuring adequate use of maternal and child health services by Mexican-American Medicaid enrollees. Factors associated with their less frequent use of these preventive health services include higher numbers of children, transportation problems, and less assistance from their support system.
- Publication
JAMA: Journal of the American Medical Association, 1994, Vol 272, Issue 4, p297
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.272.4.297