title: The impact of sociodemographic, health care system, and family function variables on prenatal care utilization in a military setting.
abstract: BACKGROUND
  Appropriate use of prenatal care is associated with more favorable perinatal outcomes. This study examines patient characteristics that influence the use of prenatal care in a total reimbursement setting.
  
  
  METHODS
  A cohort analysis was conducted with 368 new obstetric registrants in a military community hospital. The protocol involved the completion of a family function scale and prenatal care survey at the onset of care and a record review at the completion of pregnancy.
  
  
  RESULTS
  Several socioeconomic variables were highly associated with low utilization of prenatal care: low income, difficulty in finding child care, lower educational levels, and difficulty in getting transportation. The method of health care delivery, ie, care in the obstetric clinic vs family practice clinic, was also significantly associated with inadequate utilization. Finally, there appeared to be a negative association of cohesion and overall family function scores with the level of prenatal care use (P < .05).
  
  
  CONCLUSIONS
  Multiple economic factors influence the use of prenatal care even in a system with total reimbursement. Family practice care is associated with better utilization patterns; family dysfunction is associated with less prenatal care utilization.
authors.affiliation: Department of Family Practice, Madigan Army Medical Center, Tacoma, WA.
authors.forename: J P
authors.initials: JP
authors.lastname: Kugler
authors.forename: J
authors.initials: J
authors.lastname: Yeash
authors.forename: P C
authors.initials: PC
authors.lastname: Rumbaugh
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005190:Family / Q000523:psychology; D005194:Family Practice; D005260:Female; D006772:Hospitals, Military / Q000706:statistics & numerical data; D006801:Humans; D008889:Military Personnel; D009774:Obstetrics; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States