Reducing determinants of adverse birth outcomes through case management of Healthy Start Southeast Chicago participants

Background: Case management is one of healthy start core services that involves completing participant’s risk assessments to determine level of risk and coordination of care that promote maternal and child birth outcomes. This study evaluates impact of case management in increasing health screenings, risk reduction and prevention counseling and referrals for treatment rates among participants.

Methods: Data of healthy start participants (n= 4668) enrolled from (2009-2013) were abstracted from Electronic Medical Records (EMS), case manager’s intake forms and logbooks. Program evaluation using time-series method was used to evaluate impact of case management on maternal and child health of participants. Descriptive analysis of all data was performed using SPSS 11.0

Results: Participants were 100% case managed. Risk assessment for determinants of adverse pregnancy outcome showed that participants were 51.40%, 11.19% and 36.53% high risk, medium risk and low risk respectively. Prenatal participants were screened, counseled and referred for treatment for illicit drug use (99.6%, 99.6%, 10.2%), Alcohol use (99.6%, 99.5%, 4.4%), Tobacco use (98.9%, 99.6%, 19.1%), HIV (98.8%, 99.8%, 1.4%) and other STDs (98.9%, 99.5%, 21%) respectively. Infant participants were also screened and referred for treatment for drug exposure (95.3%, 1.2%), Alcohol exposure (95.3%, 0.7%), HIV exposure (95.1%, 0.4%), Growth and developmental delay (95.1%, .5%) and Asthma (95.2%, 1.4%).                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Conclusion: Case managed prenatal and infant participants have approximately 100% access to screening, counseling and referral services that improves birth outcome. Care coordination, early detection and treatment of adverse health determinants has measurable and sustainable impact on maternal and child health.