Buescher P A, Roth M S, Williams D, Goforth C M
State Center for Health and Environmental Statistics, Raleigh, NC 27611-7687.
Am J Public Health. 1991 Dec;81(12):1625-9. doi: 10.2105/ajph.81.12.1625.
Care coordination is an important component of the enhanced prenatal care services provided under the recent expansions of the Medicaid program. The effect of maternity care coordination services on birth outcomes in North Carolina was assessed by comparing women on Medicaid who did and did not receive these services.
Health program data files, including Medicaid claims paid for maternity care coordination, were linked to 1988 and 1989 live birth certificates. Simple comparisons of percentages and rates were supplemented by a logistic regression analysis.
Among women on Medicaid who did not receive maternity care coordination services, the low birth weight rate was 21% higher, the very low birth weight rate was 62% higher, and the infant mortality rate was 23% higher than among women on Medicaid who did receive such services. It was estimated that, for each $1.00 spent on maternity care coordination, Medicaid saved $2.02 in medical costs for newborns up to 60 days of age. Among the women who did receive maternity care coordination, those receiving it for 3 or more months had better outcomes than those receiving it for less than 3 months.
These results suggest that maternity care coordination can be effective in reducing low birth weight, infant mortality, and newborn medical care costs among babies born to women in poverty.
护理协调是近期医疗补助计划扩大后提供的强化产前护理服务的重要组成部分。通过比较接受和未接受这些服务的医疗补助计划参保女性，评估了北卡罗来纳州孕产妇护理协调服务对出生结局的影响。
将包括为孕产妇护理协调支付的医疗补助报销记录在内的健康项目数据文件与1988年和1989年的出生证明相链接。百分比和比率的简单比较辅以逻辑回归分析。
在未接受孕产妇护理协调服务的医疗补助计划参保女性中，低体重出生率比接受此类服务的女性高21%，极低体重出生率高62%，婴儿死亡率高23%。据估计，每花费1美元用于孕产妇护理协调，医疗补助计划在新生儿出生后60天内的医疗费用可节省2.02美元。在接受孕产妇护理协调的女性中，接受3个月或更长时间护理协调的女性比接受时间少于3个月的女性结局更好。
这些结果表明，孕产妇护理协调在降低贫困女性所生孩子的低体重出生率、婴儿死亡率和新生儿医疗费用方面可能有效。
