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

Abstract #116747

Kirsten Wallace, MA, MSPH, Chiles Center for Healthy Mothers and Babies, University of South Florida, 3111 E. Fletcher Avenue, Tampa, FL 33613, 813-974-1396, kwallac1@hsc.usf.edu and Linda A. Detman, PhD, Lawton & Rhea Chiles Center for Healthy Mothers and Babies, University of South Florida, 3111 E. Fletcher Ave., MDC100, Tampa, FL 33613-4660.

Across the four National Friendly AccessSM pilot communities, data were collected from 1,781 Medicaid eligible and uninsured women who had just given birth. The women were interviewed in the hospital about their access and use of prenatal services. The purpose of this study was to examine how demographic factors, satisfaction with care, and barriers to care effect use of prenatal care services. First, data were analyzed to examine the relationship between satisfaction with prenatal services and completion of expected number of prenatal visits. Initial analyses showed significant associations between responses to questions on a prenatal satisfaction scale and completion of care. However, after controlling for demographic characteristics (race, parity) and access measures (wait times, language concordance), satisfaction contributed only slightly to the model, suggesting that health services utilization may be driven by structural, cultural, and relational factors beneath the surface level reporting of patient satisfaction. Data were also examined to discern the relative influence of types of barriers to care (financial, systems, cognitive, and situational) on adequacy of prenatal care (classified using a modified Kotelchuck index). Approximately twenty-two percent of the population examined had inadequate prenatal care. After controlling for demographic characteristics and other types of barriers, women who reported financial barriers to care were most likely to have had inadequate care, followed by those reporting cognitive barriers, system barriers, and, finally, situational barriers. Implications of these findings are that improving use of care depends as much on reforming economic and educational policies as health care practices.

Learning Objectives: At the conclusion of this presentation, the participant will be able to

• List the at least 5 demographic and use characteristics associated with inadequate prenatal care.
• Describe the impact of consumer satisfaction with prenatal services on continuation of prenatal care.
• Assess the impact that programs to improve access to prenatal care may have, given the relative importance of particular types of barriers to care.

Keywords: Patient Satisfaction, Access to Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.