Examining the Association between Medicaid Coverage and Preterm Births Using 2010-2013 National Vital Statistics Birth Data
We conducted bivariate statistics and multivariate logistic regression on 2010-2013 National Vital Statistics Birth Data, controlling for known covariates available in the dataset, to evaluate the association between Medicaid coverage and preterm and to determine the strength of this association relative to private payer coverage.
Medicaid covers a lower number/percentage of all births than private insurance, but disproportionately covers preterm births, a statistically significant difference that holds over time. In 2013, a higher percentage of all births Medicaid covered were preterm compared to private insurance (12.7% vs. 10.9%). Among all preterm births, Medicaid covered a higher proportion than private insurance (48.9% vs. 42.3%). Medicaid was 7.5% more likely to pay for a preterm birth than a full term birth, compared to private insurance and controlling for other relevant covariates.
Effective interventions targeting pregnancy spacing, access to prenatal care, smoking cessation, and healthy weight exist and Medicaid should implement those more widely to improve birth outcomes and achieve substantial cost savings.
Learning Areas:Administer health education strategies, interventions and programs
Provision of health care to the public
Public health or related public policy
Public health or related research
Compare and contrast the association between payment source and other important factors and preterm births List the main factors associated with preterm births Discuss the importance of Medicaid coverage relative to other payment sources in supporting the costs of preterm births Formulate implications for Medicaid program improvements
Keyword(s): Perinatal Health, Birth Outcomes
Qualified on the content I am responsible for because: I am Director, Public Policy Research, at the March of Dimes where I oversee the March of Dimes' maternal and child health policy research agenda, which informs our efforts to promote programs and policies that improve health outcomes for women and children. Among my research interests is health reform's impact on maternal and child health.
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.