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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Jennifer A. Ratto, MPH, Department of International Health, Loma Linda University Graduate, 3918 Sunset Drive, Los Angeles, CA 90027 and Kathleen E. Dinsmore, MPH and MBA, Family Health Programs: Maternal, Child, and Adolescent Health, Los Angeles County Department of Health Services, Public Health Programs, 9712 Norlain Avenue, Downey, CA 90240, 213-240-8426, coco5@earthlink.net.
Objectives: This study was undertaken to measure and evaluate whether Medi-Cal* beneficiaries were able to easily access early prenatal care when enrolled under the government-funded two-plan managed care model in Los Angeles County, California.
Methods: A cross-sectional telephone survey of 1,506 prenatal care providers was conducted. Survey questions measured eight dimensions of availability/access to care. These access indicators were: whether physician provided prenatal care, specialty of physician, physician referral (when applicable), acceptance of Medi-Cal coverage, waiting period before first prenatal care visit, operating hours, days of operation, and service location.
Results: A total sample of 1,607 physician offices was identified. Primary investigator was unable to contact 101, resulting in a survey sample of 1,506 (93.7%). However, only 412 (27.4%) physician offices provided prenatal care as Medi-Cal contracted prenatal care providers. Of these offices, 99% (n=409) scheduled a Medi-Cal beneficiary within the first trimester of pregnancy. Compared with family practitioners and obstetricians-gynecologists, prenatal care access results for general practitioners were markedly better for three availability/access indicators: waiting period before first prenatal care visit, operating hours, and days of operation.
Conclusions: The transition of Medi-Cal beneficiaries into a managed care environment, with its traditional emphasis on cost-savings, created concern that access to care would be compromised or delayed, thus preventing pregnant women from receiving prenatal care in a timely manner. Results indicate that 99% of physicians identified as providing Medi-Cal prenatal care were able to schedule the initial visit within the first trimester.
*California’s Medicaid program
Learning Objectives: At the conclusion of the presentation, the participants will be able to
Keywords: Access to Care, Prenatal Care
Presenting author's disclosure statement:
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.