3258.0: Monday, November 13, 2000 - 9:45 PM

Abstract #7207

Missed opportunities for breastfeeding promotion in managed care

Marilyn A. Kacica, MD, Preventive Medicine Residency Program, University at Albany/New York State Department of Health, Empire State Plaza, Corning Tower, Room 1882, Albany, NY 12237, 518-474-1911, mak12@health.state.ny.us and Mary S. Applegate, MD, MPH, Bureau of Women's Health, New York State Department of Health, Empire State Plaza, Corning Tower, Room 1882, Albany, NY 12237.

Breastfeeding is a well-documented, cost-effective method of promoting infant health. Managed care plans (“plans”) have many opportunities to encourage breastfeeding among their clients. Plans in New York State were surveyed to assess breastfeeding promotion practices. The response rate was 31/45 (69%), with all models represented: staff, independent/preferred provider, and Medicaid-only clinic plans. On average, plans covered 1500 births per year. Each plan's results were summarized in a Breastfeeding Best Practices Score. Out of 20 possible points, the mean score was 7.3, and the range 0-16. Plans serving mostly Medicaid clients had significantly higher scores than predominantly private plans. Staff or clinic-based plans had higher scores than independent/preferred provider plans. Plan size did not affect scores. Most (71%) provided or covered the cost of breastfeeding education. Only one quarter of the plans knew how many of their clients breastfed, and few had written policies concerning breastfeeding, instead leaving decisions to providers. Only three employed a lactation specialist. Although early follow-up is key to promoting successful breastfeeding, 45% of plans had no information about infant follow-up. Of the remainder, three quarters reported seeing breastfeeding infants within 2 weeks after hospital discharge, but in six plans, infants are seen later than two weeks. Among predominantly Medicaid plans, significantly more reported that infants were seen within two weeks. Conclusion: Most managed care plans in New York make little effort to support breastfeeding. They are missing significant opportunities to promote infant health through breastfeeding.

Learning Objectives:

  1. Identify key opportunities in managed care settings to promote breastfeeding.
  2. Compare current breastfeeding promotion practices in managed care settings to optimal practices.
  3. Describe differences in level of breastfeeding support among different types of managed care plans.

Keywords: Breastfeeding, Managed Care

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA