Improving access to quality prenatal care (PNC) continues to be a key strategy to decrease the incidence of adverse pregnancy outcomes in the U.S. However, a significant portion of U.S. women, particularly low-income women and women of color still fail to get adequate PNC. This study examined the relationship between satisfaction with PNC and subsequent PNC utilization. Four hundred and eleven African-American women 18 years or over, on Medicaid (n=123) or privately insured (n=288) who received PNC at a large managed care organization were interviewed before 29 weeks gestation to ascertain their satisfaction with prenatal care. Following delivery, each woman's medical chart was abstracted to obtain prenatal care utilization information. Woman's satisfaction with prenatal care was correlated with a measure of adequacy of PNC utilization that accounted for the date of interview as well as the date of delivery. The mean satisfaction score for this population was 80.1. Eleven percent of the women received an inadequate number of PNC visits even though they had initiated care in the first or second trimester of pregnancy. However, preliminary unadjusted analysis suggests no evidence of a relationship between satisfaction with PNC care and subsequent utilization (Odds Ratio, .94, 95% Confidence Interval .53-1.68). These preliminary results suggest that among insured African-American women receiving PNC through a large managed care organization, factors other than satisfaction with the prenatal care experience may predict subsequent utilization. These factors may need to be considered to ensure that women who enter the prenatal care delivery system obtain adequate care.
Learning Objectives: At the conclusion of this session, the participant will be able to: 1) Describe past findings concerning the relationship between satisfaction and prenatal care utilization; 2) Describe the importance of ascertaining the factors which affect prenatal care utilization once a woman has initiated care; and, 3) Conceptualize an appropriate research design to consider the relationship between prenatal care satisfaction and utilization.
Keywords: Prenatal Care, 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.