Effects of a Medicaid home visiting perinatal program on maternal and child health: Who benefits the most?
Methods The study population is all Medicaid eligible women who gave birth in 2009 and 2010, and their infants. We used statewide maternal and infant linked data spanning from the preconceptional period until the end of the first year after birth, including Medicaid claims, vital records, and program participation. This was a quasi-experimental evaluation of the MIHP effectiveness, specifically using propensity score matching.
Results Overall, MIHP participants had higher odds of receiving any prenatal care (OR=2.9), appropriate prenatal care (OR=1.06), appropriate postnatal checkups (OR=1.5) compared to matched equivalent non-participants. Their infants had lower odds of low birth weight (OR=0.9), very low birth weight (OR=0.7), and higher odds of receiving well-child visits (OR=1.7) and the appropriate number of well-child visits (OR=1.5). All results were significant (p<0.05). Women who enrolled in MIHP during the 1st trimester, teenage mothers, and first-time mothers experienced stronger MIHP effects.
Conclusions There was a pattern of significant favorable MIHP effects across a range of maternal and infant outcomes beginning during pregnancy, continued at birth, and sustained through the first year after birth. Early MIHP enrollees, teenage, and first-time mothers seemed to benefit more from MIHP.
Learning Areas:Biostatistics, economics
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Evaluate the effects of a Medicaid home visiting program in subpopulations of mothers and infants in Michigan
Qualified on the content I am responsible for because: I am the principal investigator and co-principal investigator on multiple grants, including federally funded on topics related to maternal and child health and the prevention of cancer. I am the Primary Investigator on the quasi-experimental evaluation of the Medicaid Maternal and Infant Health Program in Michigan.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.