Health Insurance Coverage-Enrollment and Adequacy of Prenatal Care Utilization

Most studies have concluded that good prenatal care plays an essential role in improving birth outcomes, and numerous reports have documented barriers to adequate prenatal care. The relationship between health care insurance eligibility and enrollment procedures and adequacy of prenatal care, however, has not been suitably investigated. This study used data from a statewide representative sample of recently delivered women in South Carolina to assess (1) patterns of health care insurance source and (2) the independent effects of Medicaid enrollment and application procedures on receipt of prenatal care. Health insurance during pregnancy varied by sociodemographic characteristics. Black women's experiences with Medicaid enrollment and application procedures were associated with less than adequate prenatal care. Programmatic efforts and policies should emphasize further improvement in the systems of health care access and delivery to disadvantaged women.

[1]  Keith Wailoo.  Health Care Divided: Race and Healing a Nation (review) , 2002 .

[2]  D. B. Smith.  Health care divided , 1999 .

[3]  J. A. Martin,et al.  The changing pattern of prenatal care utilization in the United States, 1981-1995, using different prenatal care indices. , 1998, JAMA.

[4]  R. Kirby.  The quality of vital perinatal statistics data, with special reference to prenatal care. , 1997, Paediatric and perinatal epidemiology.

[5]  G. Kenney,et al.  Local responses to expanded Medicaid coverage for pregnant women. , 1995, The Milbank quarterly.

[6]  M. B. Carpenter.  The impact of legislation designed to reduce infant mortality. , 1995, The Journal of perinatal & neonatal nursing.

[7]  W. Ray,et al.  Presumptive eligibility for pregnant Medicaid enrollees: its effects on prenatal care and perinatal outcome. , 1994, American journal of public health.

[8]  M. Kotelchuck,et al.  An evaluation of the Kessner Adequacy of Prenatal Care Index and a proposed Adequacy of Prenatal Care Utilization Index. , 1994, American journal of public health.

[9]  W. Ray,et al.  Expanded Medicaid coverage for pregnant women to 100 percent of the federal poverty level. , 1994, American journal of preventive medicine.

[10]  T. Bennett,et al.  Access to prenatal care following major Medicaid eligibility expansions. , 1993, JAMA.

[11]  D. Williams,et al.  An evaluation of the impact of maternity care coordination on Medicaid birth outcomes in North Carolina. , 1991, American journal of public health.

[12]  J. Weiss,et al.  Source of bias in prenatal care utilization indices: implications for evaluating the Medicaid expansion. , 1991, American journal of public health.

[13]  The Pregnancy Risk Assessment Monitoring System: design, questionnaire, data collection and response rates. PRAMS Working Group. , 1991, Paediatric and perinatal epidemiology.

[14]  E. Hodkinson,et al.  Prenatal Care Use and Health Insurance Status , 1991, Journal of health care for the poor and underserved.

[15]  W. Ray,et al.  Effects of Medicaid eligibility expansion on prenatal care and pregnancy outcome in Tennessee. , 1990, JAMA.

[16]  S. S. Brown,et al.  Drawing women into prenatal care. , 1989, Family planning perspectives.

[17]  S Greenland,et al.  Modeling and variable selection in epidemiologic analysis. , 1989, American journal of public health.

[18]  Brown Ss.  Prenatal care : reaching mothers, reaching infants , 1988 .