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Estimating the effect of Prenatal Care Coordination in Wisconsin: A sibling fixed effects analysis.

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  • معلومة اضافية
    • المصدر:
      Publisher: Blackwell Country of Publication: United States NLM ID: 0053006 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1475-6773 (Electronic) Linking ISSN: 00179124 NLM ISO Abbreviation: Health Serv Res Subsets: MEDLINE
    • بيانات النشر:
      Publication: Malden, MA : Blackwell
      Original Publication: Chicago, Hospital Research and Educational Trust.
    • الموضوع:
      Infant, Low Birth Weight* ; Pregnancy Outcome* ; Premature Birth*; Medicaid/*statistics & numerical data ; Prenatal Care/*standards ; Prenatal Care/*statistics & numerical data; Adult ; Cohort Studies ; Female ; Humans ; Longitudinal Studies ; Pregnancy ; United States ; Wisconsin
    • نبذة مختصرة :
      Objective: To estimate Prenatal Care Coordination's (PNCC) effect on birth outcomes for Wisconsin Medicaid-covered deliveries.
      Data Source: A longitudinal cohort of linked Wisconsin birth records (2008-2012), Medicaid claims, and state-administered social services.
      Study Design: We defined PNCC treatment dichotomously (none vs. any) and by service level (none vs. assessment/care plan only vs. service uptake). Outcomes were birthweight (grams), low birthweight (<2500 g), gestational age (completed weeks), and preterm birth (<37 weeks). We estimated PNCC's effect on birth outcomes, adjusting for maternal characteristics, using inverse-probability of treatment weighted and sibling fixed effects regressions.
      Data Collection/extraction Methods: We identified 136 224 Medicaid-paid deliveries, of which 33 073 (24.3 percent) linked to any PNCC claim and 22 563 (16.6 percent) linked to claims for PNCC service uptake.
      Principal Findings: Sibling fixed effects models-which best adjust for unobserved confounding and treatment selection-produced the largest estimates for all outcomes. For example, in these models, PNCC service uptake was associated with a 1.3 percentage point (14 percent) reduction and a 1.8 percentage point (17 percent) reduction in the probabilities of low birthweight and preterm birth, respectively (all P < .05).
      Conclusions: PNCC's modest but significant improvement of birth outcomes should motivate stronger PNCC outreach and implementation of similar programs elsewhere.
      (© Health Research and Educational Trust.)
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    • Grant Information:
      P2C HD047873 United States HD NICHD NIH HHS; T32 HD007014 United States HD NICHD NIH HHS; UL1 TR000427 United States TR NCATS NIH HHS; UL1 TR002373 United States TR NCATS NIH HHS
    • Contributed Indexing:
      Keywords: Medicaid; care coordination; prenatal
    • الموضوع:
      Date Created: 20191109 Date Completed: 20200824 Latest Revision: 20240725
    • الموضوع:
      20240726
    • الرقم المعرف:
      PMC6980950
    • الرقم المعرف:
      10.1111/1475-6773.13239
    • الرقم المعرف:
      31701531