The Impact of Prenatal Care Coordination on Birth Outcomes

作者：Van Dijk Julie A Willems^*; Anderko Laura; Stetzer Frank

来源：Journal of Obstetric Gynecologic and Neonatal Nursing, 2011, 40(1): 98-108.

DOI：10.1111/j.1552-6909.2010.01206.x

• prenatal care coordinationbirth outcomeslow birth weightcase managementservice intensity

Objective
To measure the impact of a Medicaid benefit called Prenatal Care Coordination (PNCC) on healthy birth outcomes.
Design
A cross sectional design was used to compare the birth outcomes of infants born to women who received Medicaid and PNCC services to the birth outcomes of infants born to women who received Medicaid but did not receive PNCC services.
Setting
Services were provided in community based settings in Wisconsin.
Participants
Of the 45,406 Medicaid births in 2001 to 2002, 10,715 (23.6%) mothers received PNCC services and were considered the treatment group.
Methods
Secondary analyses of birth certificate and Medicaid billing data were conducted using binary logistic regression analyses to evaluate the impact of PNCC and the hours of PNCC service on birth outcomes.
Results
Controlling for nine covariates, women who received PNCC services were found to have significantly better birth outcomes, including fewer low-birth-weight infants (odds ratio [OR]=0.84; 95% CI [.777, .912]), fewer very-low-birth-weight infants (OR=0.70; 95% CI [.587, .855]), fewer preterm infants (OR=0.83; 95% CI [.776, .890]), and fewer infants transferred to the neonatal intensive care units (OR=.83; 95% CI [.759, .906]). Women who received 6 or more hours of service were less likely to deliver infants with poor birth outcomes.
Conclusions
The use of PNCC is an effective strategy for preventing adverse birth outcomes. Strategies to further enhance PNCC's positive benefits include increased outreach and engagement with at risk pregnant women.

• 出版日期2011-2