Obstetric care and payment source: do low-risk Medicaid women get less care?
OBJECTIVE
This study examined whether Medicaid-insured women at low risk receive less adequate obstetrical care than privately insured women.


METHODS
Low-risk women who were cared for by a random sample of obstetrical providers in Washington State were randomly selected. Information on all prenatal and intrapartum services was abstracted from medical records. Service information was aggregated into standardized resource-use units. Results compared Medicaid-insured women with those who were privately insured.


RESULTS
Medicaid-insured women were significantly younger (22.5 years vs 26.9 years) and averaged 6% fewer visits than privately insured women. Nonetheless, Medicaid status had no meaningful association with prenatal, intrapartum, or overall resource use. Some variation occurred in individual resources received. Medicaid-insured women had 38.8% more resources expended on testing for sexually transmitted diseases. Privately insured women had more resources expended on alpha-fetoprotein testing and on amniocentesis. There were no meaningful differences in birthweight or gestational age at delivery.


CONCLUSIONS
In this study of women who entered obstetrical care at low risk, similar care and resources were expended on Medicaid-insured and on privately insured women.
Dobie
S
S
WAMI Rural Health Research Center, University of Washington, School of Medicine, Seattle, USA.
Hart
L G
LG
Fordyce
M
M
Andrilla
C H
CH
Rosenblatt
R A
RA
D000328:Adult; D005260:Female; D015276:Health Care Rationing / Q000191:economics*; D006801:Humans; D007348:Insurance, Health; D016014:Linear Models; D008484:Medicaid; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000191:economics* / Q000706:statistics & numerical data; D011897:Random Allocation; D012307:Risk Factors; D014481:United States; D014861:Washington