title: The impact of managed care on drug-dependent pregnant and postpartum women and their children.
abstract: In the shift from fee-for-service (FFS) to managed care (MC), many drug user treatment programs have eliminated all but basic services, lessening short-term costs without considering long-term consequences. This study explored maternal and infant outcomes at an urban drug user treatment center for pregnant drug-dependent women under FFS (1995) vs. MC (2000) service periods. The two groups had similar birth parameters, but the MC group had more fetal and infant deaths, decreased immunization rates, and greater incidences of social services intervention. While these data are correlational and need to be interpreted with caution, they suggest poorer outcomes for drug-exposed children under MC and invite further study of short- and long-term consequences of such change.
authors.affiliation: School of Medicine, Department of Pediatrics, The Johns Hopkins University, Baltimore, MD 21224, USA. ljansson@jhmi.edu
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Jansson
authors.forename: Dace S
authors.initials: DS
authors.lastname: Svikis
authors.forename: Martha
authors.initials: M
authors.lastname: Velez
authors.forename: Erik
authors.initials: E
authors.lastname: Fitzgerald
authors.forename: Hendrée E
authors.initials: HE
authors.lastname: Jones
mesh_terms: D000328:Adult; D002648:Child; D003710:Demography; D005260:Female; D005313:Fetal Death; D006801:Humans; D007223:Infant; D008329:Managed Care Programs; D049590:Postpartum Period; D011247:Pregnancy; D011584:Psychology; D019966:Substance-Related Disorders / Q000453:epidemiology*