Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109711

Virginia L. Miller, DrPH¹, Julie George, MS², and Lynnette Essenmacher, BS¹. (1) Center for Healthcare Effectiveness Research, Wayne State University School of Medicine, RM 121 Shiffman Medical Library, 4325 Brush Street, Detroit, MI 48201, 313.993.1332, vmiller@med.wayne.edu, (2) Department of Internal Medicine, Wayne State University School of Medicine, UHC-5C, 5201 St. Antoine Street, Detroit, MI 48201

The Pregnancy Risk Assessment and Monitoring System (PRAMS) Michigan data were employed to examine the following research questions: 1) Were there differences in the source and payment for prenatal care during 1996 and 2000? and 2) Were there differences in the reported type of maternal health insurance and infant insurance during 1996 and 2000? With the dynamic policy changes related to maternal and child health, i.e. Medicaid managed care, PRWORA, and SCHIP, PRAMS data offer the opportunity to assess changes in maternal and child health indicators and to measure statewide progress towards meeting goals in improving maternal and infant health. Between 1996 and 2000, there was a decrease in the proportion of women reporting having Medicaid before pregnancy (16%; 12% p = 0.0048) and there was in increase in the proportion of women reporting having other insurance before pregnancy (69%; 74% p=0.0342). A model was developed to learn if there were differences in infant outcomes associated with maternal prenatal characteristics. The infant outcome variable was low birthweight and the maternal prenatal variables included alcohol use, tobacco use, weight, race, age, payment for care, and income. Related to health services utilization, a variable termed continuous care, consisting of the all combinations of prenatal and well baby care, was included in the model. Our presentation will include the specific study findings, discussion of the methodological issues, application to evidence-based practice and future directions for this area of study.

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