The College of Human Medicine, Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University, B-225 West Fee Hall, East Lansing, MI 48824, USA.
Matern Child Health J. 2010 Jan;14(1):110-20. doi: 10.1007/s10995-008-0428-z. Epub 2008 Dec 16.
Medicaid insures an estimated 43% of all births in Michigan and provides additional funding for enhanced prenatal services (EPS). The objectives of this study are to report on the (1) use of statewide administrative data to examine risk characteristics and EPS enrollment of Medicaid-insured pregnant women in Michigan; and (2) presence and extent of a broad range of risk factors in a sample of EPS participants in Michigan, using a newly developed two-tier, risk screener and assessment tool. This study uses Vital Records, Medicaid and other data to describe EPS participation by maternal risks in the statewide population of Medicaid-insured pregnant women (54,582 in the fiscal year 2005). The screener study data is a convenience sample of 2,203 women screened between February 2005 and October 2007. The administrative data indicates that 26% of Medicaid-eligible pregnant women had EPS contact. Most women with health behavior risks, such as smoking and drug use, had no contact with EPS (68-72%). Approximately 58% of all Medicaid-insured women had zero to two co-occurring risks, while 42% had three or more of the analyzed risks. Among screened women who smoke, 9% smoked more than a pack a day. Approximately 34% of women with a depression screen scored in the moderately or severely depressed range. The results of this study suggest great opportunity for EPS enhancement by improving the capacity to identify and engage women with modifiable risks, match interventions to specific health problems, and deliver services at an intensity warranted by the risk level.
医疗保险为密歇根州约 43%的分娩提供保险，并为强化产前服务 (EPS) 提供额外资金。本研究的目的是：(1) 使用全州范围的行政数据，检查密歇根州医疗保险孕妇的风险特征和 EPS 登记情况；(2) 在密歇根州 EPS 参与者样本中，使用新开发的两层次风险筛选器和评估工具，报告广泛的风险因素的存在和程度。本研究使用生命记录、医疗补助和其他数据来描述全州范围内医疗保险孕妇（2005 财年有 54582 名）中 EPS 参与情况的母性风险。筛选研究数据是 2005 年 2 月至 2007 年 10 月期间接受筛选的 2203 名妇女的便利样本。行政数据表明，26%的符合医疗补助资格的孕妇有 EPS 接触。大多数有健康行为风险（如吸烟和吸毒）的妇女与 EPS 没有接触（68-72%）。大约 58%的所有医疗保险孕妇有零到两个共同的风险，而 42%的孕妇有三个或更多分析的风险。在筛选出的吸烟妇女中，有 9%的人每天吸烟超过一包。大约 34%的有抑郁筛查的妇女处于中度或重度抑郁范围内。这项研究的结果表明，通过提高识别和参与可改变风险的妇女的能力、将干预措施与特定健康问题相匹配以及根据风险水平提供必要的服务强度，有很大机会增强 EPS。
