ACCESS TO CARE: THE EFFECT OF INSURANCE STATUS ON PRENATAL CARE AND BIRTH OUTCOMES

2.50
Hdl Handle:
http://hdl.handle.net/10755/157271
Type:
Presentation
Title:
ACCESS TO CARE: THE EFFECT OF INSURANCE STATUS ON PRENATAL CARE AND BIRTH OUTCOMES
Abstract:
ACCESS TO CARE: THE EFFECT OF INSURANCE STATUS ON PRENATAL CARE AND BIRTH OUTCOMES
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Coursen, Cristi C., PhD, WHNP-BC
P.I. Institution Name:Arizona State University
Title:Assistant Professor, Program Director Women's Health Specialty
Contact Address:500 N. 3rd Street, Phoenix, AZ, 85004, USA
Co-Authors:Barbara L. Wilson
PURPOSES/AIMS: Measuring the adequacy of prenatal care in terms of number of prenatal visits, and whether the timing of initiation of prenatal care due to insurance status are causal factors in determining the relationship between prenatal care and improved birth outcomes, is the purpose of this study. This research will examine whether there are differences in birth outcomes among women with private insurance, Medicaid insurance, and no insurance in their ability to access prenatal care, initiation of prenatal care, and number of prenatal visits. Findings may illuminate whether good birth outcomes are jeopardized by insurance status alone, or whether it is the adequacy of prenatal care as measured by the number of visits and the timing of initiation of care.
RATIONALE/CONCEPTUAL BASIS/BACKGROUND: Prenatal care has historically been viewed as an essential component of improved birth outcomes, and various endogenous relationships such as socioeconomic status have been studied to explain the association between prenatal care utilization and adverse outcomes. Health insurance status whether private, public, or being uninsured may affect prenatal care initiation and utilization. Medicaid was originally designed to address health care inequality. However, it does not provide care for all of the poor, and pregnant women may be at disadvantage for receiving adequate prenatal care and good birth outcomes due to their inability to obtain and maintain coverage due to eligibility requirements.
METHODS: Access to and utilization of prenatal care will be evaluated along with multiple dimensions of birth outcomes using a secondary analysis of data from Arizona HealthQuery (AZHQ). AZHQ is a community health data system managed through the Center for Health Information and Research (CHiR) at ASU. Methodology will involve multivariate statistical techniques: time and point of entry into prenatal care (Cox duration regression models), number of prenatal visits (count regression models), insurance status (multinominal regression analysis), and birth outcomes (ordinary and logistic regressions to examine gestational age, birth weight, APGAR scores, NICU admission and/or newborn transport). All singleton births in Maricopa County for a ten year period (1997-2007) will be analyzed to examine whether differences in birth outcomes exist among women based on insurance type, and whether the womanÆs ability to maintain Medicaid coverage during this time period made any significant difference in access and utilization of prenatal care.
RESULTS: Research is in progress
IMPLICATIONS: Insurance eligibility for pregnant women in Arizona is not presumptive. This analysis may reveal RESULTS: that could add precision to health policy-making in order to improve access to prenatal care, and in particular, improve birth outcomes.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleACCESS TO CARE: THE EFFECT OF INSURANCE STATUS ON PRENATAL CARE AND BIRTH OUTCOMESen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157271-
dc.description.abstract<table><tr><td colspan="2" class="item-title">ACCESS TO CARE: THE EFFECT OF INSURANCE STATUS ON PRENATAL CARE AND BIRTH OUTCOMES</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Coursen, Cristi C., PhD, WHNP-BC</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Arizona State University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor, Program Director Women's Health Specialty</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">500 N. 3rd Street, Phoenix, AZ, 85004, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Cristi.Coursen@asu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Barbara L. Wilson</td></tr><tr><td colspan="2" class="item-abstract">PURPOSES/AIMS: Measuring the adequacy of prenatal care in terms of number of prenatal visits, and whether the timing of initiation of prenatal care due to insurance status are causal factors in determining the relationship between prenatal care and improved birth outcomes, is the purpose of this study. This research will examine whether there are differences in birth outcomes among women with private insurance, Medicaid insurance, and no insurance in their ability to access prenatal care, initiation of prenatal care, and number of prenatal visits. Findings may illuminate whether good birth outcomes are jeopardized by insurance status alone, or whether it is the adequacy of prenatal care as measured by the number of visits and the timing of initiation of care. <br/>RATIONALE/CONCEPTUAL BASIS/BACKGROUND: Prenatal care has historically been viewed as an essential component of improved birth outcomes, and various endogenous relationships such as socioeconomic status have been studied to explain the association between prenatal care utilization and adverse outcomes. Health insurance status whether private, public, or being uninsured may affect prenatal care initiation and utilization. Medicaid was originally designed to address health care inequality. However, it does not provide care for all of the poor, and pregnant women may be at disadvantage for receiving adequate prenatal care and good birth outcomes due to their inability to obtain and maintain coverage due to eligibility requirements. <br/>METHODS: Access to and utilization of prenatal care will be evaluated along with multiple dimensions of birth outcomes using a secondary analysis of data from Arizona HealthQuery (AZHQ). AZHQ is a community health data system managed through the Center for Health Information and Research (CHiR) at ASU. Methodology will involve multivariate statistical techniques: time and point of entry into prenatal care (Cox duration regression models), number of prenatal visits (count regression models), insurance status (multinominal regression analysis), and birth outcomes (ordinary and logistic regressions to examine gestational age, birth weight, APGAR scores, NICU admission and/or newborn transport). All singleton births in Maricopa County for a ten year period (1997-2007) will be analyzed to examine whether differences in birth outcomes exist among women based on insurance type, and whether the woman&AElig;s ability to maintain Medicaid coverage during this time period made any significant difference in access and utilization of prenatal care. <br/>RESULTS: Research is in progress <br/>IMPLICATIONS: Insurance eligibility for pregnant women in Arizona is not presumptive. This analysis may reveal RESULTS: that could add precision to health policy-making in order to improve access to prenatal care, and in particular, improve birth outcomes.<br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:43:12Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:43:12Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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