Can prenatal care impact future well-child visits? The experience of a low income population in New York State Medicaid managed care.
To examine the association between maternal characteristics and care patterns and the subsequent utilization of well-child visits in a low income population in New York State (NYS). We analyzed Medicaid managed care birth data from 2004 to 2005 linked to an administrative database to obtain information on preventive well-care visits for the child. The outcome variable was whether the child had five or more well-child visits (WCVs) in their first 15 months of life. Of the 101,461 children in this study 67% had received five or more well-child visits by 15 months of age. This varied by region with a lesser proportion of children receiving well-child visits in New York City (NYC) and a higher proportion in the rest-of-state. Children born to mothers with intensive and adequate prenatal care were significantly more likely to have the necessary well-child visits. Foreign born women were more likely than US born women to bring their children in for well-child visits across all racial and ethnic groups. This study indicated that women who received adequate prenatal care were more likely to bring their children to well-child visits even after adjusting for maternal and infant characteristics. Maternal birthplace modified the association between race and well-child visits. The black-white disparity typically seen in WCVs in the United States was not found in NYC among children of US born women in Medicaid managed care.
New York State Department of Health, Division of Quality and Evaluation, Office of Health Insurance Programs, Albany, NY 12237, USA. ljw02@health.state.ny.us
Lindsay W
LW
Cogan
Raina E
RE
Josberger
Foster C
FC
Gesten
Patrick J
PJ
Roohan
D000293:Adolescent; D000328:Adult; D002662:Child Health Services / Q000706:statistics & numerical data* / Q000639:trends; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008329:Managed Care Programs; D008423:Maternal Age; D008484:Medicaid; D009518:New York; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011203:Poverty; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult