Health promotion and psychosocial services and women's assessments of interpersonal prenatal care in Medicaid managed care.
OBJECTIVE
If prenatal health promotion and psychosocial support services are to remain accessible to Medicaid eligible women, evidence is needed as to whether the services improve care and benefit women in ways that matter to health plans. The aims of this study are to determine whether prenatal health promotion and psychosocial services are associated with better interpersonal care and greater satisfaction with care; and whether the effects on interpersonal care help explain satisfaction with care.


METHODS
A telephone survey of 363 African American, Latina (US and nonUS-born) and White women receiving prenatal care in four Medicaid public health plans in California in 2001. Multivariate regression analyses were done with adjustments for potentially confounding variables.


METHODS
Independent variables included dichotomous variables for health promotion advice (five separate areas) and composite scales for psychosocial assessment (six areas combined). Dependent variables included satisfaction with care, and indices for interpersonal care (communication, decision-making, and interpersonal style).


RESULTS
Women who report receiving health promotion or psychosocial services also report receiving better interpersonal care and rate their satisfaction with care higher. Receiving either type of support service is associated with higher quality communication, decision-making and interpersonal style. The effects of the support services on satisfaction are, in turn, explained by the effects on interpersonal care.


CONCLUSIONS
Prenatal health promotion and psychosocial services have associated benefits to enrollees that should matter to Medicaid health plans and their providers.
Korenbrot
Carol C
CC
Institute for Health Policy Studies, University of California San Francisco, CA, USA. ckoren@itsa.ucsf.edu
Wong
Sabrina T
ST
Stewart
Anita L
AL
D000293:Adolescent; D000328:Adult; D003625:Data Collection; D005260:Female; D006293:Health Promotion; D006801:Humans; D008329:Managed Care Programs / Q000458:organization & administration*; D008484:Medicaid / Q000458:organization & administration*; D017060:Patient Satisfaction; D011295:Prenatal Care; D011369:Professional-Patient Relations; D011787:Quality of Health Care; D012944:Social Support; D014481:United States