Author: M Qayad, Georgia Division of Public Health
Title: Impact of Perinatal Case Management (PCM) on prenatal care in Georgia
Background. Medicaid mothers begin prenatal care later and are less likely to receive adequate prenatal care (APC) than non-Medicaid mothers. The Georgia (GA) Medicaid Program introduced PCM in 1989 to improve Medicaid mothers’ access to and use of prenatal services.
Objective. To assess the impact of PCM on prenatal care among GA's Health Districts.
Methods. We linked 1996 birth and Medicaid-delivery claims data, and identified 51,446 Medicaid mothers. For PCM and nonPCM mothers in each district, we computed the percent with APC using the modified Kessner Index. We used risk ratios (RR) and 95% confidence intervals to assess the impact of PCM on APC by district, controlling for age, education, and race by stratified analysis.
Results. PCM mothers were more likely to be 20+ years, black, and have 12+ years education. In the districts, PCM mothers with APC ranged from 53% to 81% (median 71%), while nonPCM mothers ranged from 48% to 86% (median 65%). APC was significantly increased among PCM mothers for 11/19 districts (RR>1). When age, race, and education was controlled, PCM was associated with a significant increase in APC in 6 districts, and not with a significant drop in any district.
Conclusion. PCM was associated with an increase in the proportion of Medicaid mothers receiving APC even when age, race and education were controlled. These results were demonstrated in multiple districts.
Learning Objectives: 1. describe adequacy of prenatal care 2. describe PCM 3. describe Modified Kessner Index 4. calculate the impact of PCM,using Relative Risk (RR)
Keywords: Prenatal Care,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment