Preventing low birth weight in Illinois: outcomes of the family case management program.

OBJECTIVES

In the mid 1980's the federal government passed legislation allowing states to expand their Medicaid programs for pregnant women. States were also offered matching funds for "enhanced" prenatal care services. The Illinois Family Case Management (FCM) Program targets low-income women and aims to reduce barriers to prenatal care and infant healthcare utilization and also provides health education. We evaluated the outcome of the Illinois Family Case Management Program (FCM) in preventing low birth weight in Winnebago County.

METHODS

A total of 6,440 participants were included in this study. Logistic regression was used to test whether number of visits or total hours of visitation were significant protective factors against low birth weight.

RESULTS

While participating in the FCM Program resulted in a lower rate of low birth weight delivery, neither increasing time with a family case manager nor increasing number of visits showed statistically significant additional protection against low birth weight delivery after adjustment for potential confounding factors.

CONCLUSION

In order to further improve program outcomes, efforts need to include improving quality of interventions or developing new interventions rather than simply increasing the amount of current intervention for each participant. The cost effectiveness of shifting FCM Program efforts away from infants (aged 0-1 year) towards improved prenatal interventions should be evaluated.