Managed care and infant health: an evaluation of Medicaid in the US.
In this study, we examine the effects of Medicaid managed care (MMC) on prenatal care utilization, infant birth weight, pre-term birth, and use of cesarean section in the United States. We obtain separate estimates of the effect of primary care case management managed care programs and health maintenance organization managed care plans on these outcomes. The results suggest the following: among white, non-Hispanic women, MMC was associated with a 2 percent decrease in the number of prenatal care visits and a 3-5 percent increase the incidence of inadequate prenatal care; MMC was associated with a significant increase in the incidence pre-term birth for non-Hispanic white women, but that this association does not appear to be causal; and MMC had no association with the incidence of cesarean section.
Kaestner
Robert
R
Department of Economics, Institute of Government and Public Affairs, University of Illinois-Chicago, 815 West Van Buren Street, Suite 525, Chicago, ILL, 60607-3525, USA. kaestner@uic.edu
Dubay
Lisa
L
Kenney
Genevieve
G
D001724:Birth Weight; D002585:Cesarean Section / Q000191:economics / Q000706:statistics & numerical data; D005006:Ethnicity; D005260:Female; D006279:Health Maintenance Organizations / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D017533:Marital Status; D008484:Medicaid / Q000458:organization & administration* / Q000706:statistics & numerical data; D018803:Models, Economic; D011243:Preferred Provider Organizations / Q000458:organization & administration* / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000191:economics / Q000208:ethnology; D011295:Prenatal Care / Q000191:economics / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States