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产前保健是否会影响未来的儿童健康检查?纽约州医疗补助管理式医疗中低收入人群的经验。

Can prenatal care impact future well-child visits? The experience of a low income population in New York State Medicaid managed care.

机构信息

New York State Department of Health, Division of Quality and Evaluation, Office of Health Insurance Programs, Albany, NY 12237, USA.

出版信息

Matern Child Health J. 2012 Jan;16(1):92-9. doi: 10.1007/s10995-010-0710-8.

Abstract

To examine the association between maternal characteristics and care patterns and the subsequent utilization of well-child visits in a low income population in New York State (NYS). We analyzed Medicaid managed care birth data from 2004 to 2005 linked to an administrative database to obtain information on preventive well-care visits for the child. The outcome variable was whether the child had five or more well-child visits (WCVs) in their first 15 months of life. Of the 101,461 children in this study 67% had received five or more well-child visits by 15 months of age. This varied by region with a lesser proportion of children receiving well-child visits in New York City (NYC) and a higher proportion in the rest-of-state. Children born to mothers with intensive and adequate prenatal care were significantly more likely to have the necessary well-child visits. Foreign born women were more likely than US born women to bring their children in for well-child visits across all racial and ethnic groups. This study indicated that women who received adequate prenatal care were more likely to bring their children to well-child visits even after adjusting for maternal and infant characteristics. Maternal birthplace modified the association between race and well-child visits. The black-white disparity typically seen in WCVs in the United States was not found in NYC among children of US born women in Medicaid managed care.

摘要

为了考察在纽约州(NYS)的低收入人群中,母亲的特征和护理模式与随后的儿童常规健康检查利用之间的关系。我们分析了 2004 年至 2005 年的医疗补助管理式医疗保健出生数据,并将其与行政数据库联系起来,以获取有关儿童预防保健检查的信息。因变量是儿童在 15 个月的生命中是否有五次或更多次常规健康检查(WCVs)。在这项研究的 101461 名儿童中,67%的儿童在 15 个月大时接受了五次或更多次常规健康检查。这因地区而异,在纽约市(NYC)接受常规健康检查的儿童比例较低,而在全州其他地区接受常规健康检查的儿童比例较高。接受密集和充分产前保健的母亲所生的儿童更有可能接受必要的常规健康检查。与美国出生的妇女相比,外国出生的妇女更有可能在所有种族和族裔群体中带孩子进行常规健康检查。这项研究表明,即使在调整了母亲和婴儿特征后,接受充分产前保健的妇女更有可能带孩子去常规健康检查。母亲的出生地改变了种族与常规健康检查之间的关系。在美国,常规健康检查中常见的黑人和白人之间的差距在纽约市的医疗补助管理式医疗保健中并没有出现在美国出生的妇女所生孩子中。

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