Health service use and outcomes among disabled Medicaid pregnant women.
OBJECTIVE
We investigated differences in health service use and pregnancy outcomes among women enrolled in Medicaid under eligibility categories for the blind and disabled and those enrolled under other eligibility categories.


METHODS
We used Medicaid enrollment and claims data to create episodes of pregnancy- and delivery-related care for women with and without disabilities who had Medicaid-covered deliveries in Florida, Georgia, and New Jersey during 1995 and Texas during 1997. We linked birth certificate information on prenatal care and birth outcomes to the files for Georgia and Texas. We then computed the unadjusted and adjusted odds ratios for the receipt of selected routine prenatal and illness-related services and the occurrence of selected pregnancy outcomes among women with disabilities relative to women without disabilities.


RESULTS
In all states, women with disabilities were more likely than women without disabilities to have had continuous Medicaid coverage from preconception through the postnatal period. Women with disabilities were equally or less likely to have received adequate prenatal care compared to women without disabilities in the two study states with these data. They were also more likely to have had emergency room visits, hospital admissions during pregnancy, cesarean deliveries, and readmissions within 3 months of delivery in all study states. We also found women with disabilities to have been more likely to deliver preterm and low birthweight infants.


CONCLUSIONS
Our results suggest that opportunities exist to improve access to prenatal care among women with disabilities enrolled in Medicaid under blind and disabled eligibility categories who become pregnant.
Gavin
Norma I
NI
RTI International, Research Triangle Park, North Carolina 27709-2194, USA. gavin@rti.org
Benedict
M Beth
MB
Adams
E Kathleen
EK
D000328:Adult; D006233:Persons with Disabilities; D005260:Female; D005431:Florida / Q000453:epidemiology; D005845:Georgia / Q000453:epidemiology; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008429:Maternal Welfare / Q000706:statistics & numerical data*; D008484:Medicaid / Q000706:statistics & numerical data*; D009515:New Jersey / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011295:Prenatal Care / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D016387:Women's Health