Piper J M, Ray W A, Griffin M R
Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2637.
JAMA. 1990 Nov 7;264(17):2219-23.
To investigate the effects of a 1985 Tennessee Medicaid regulatory change that expanded eligibility coverage specifically for married women during pregnancy, we studied vital statistics files linked to Medicaid enrollment files. The greatest Medicaid coverage increase in terms of an absolute difference in rates and the number of women covered occurred in white married women younger than 25 years with less than 12 years of education, where enrollment increased 18%. However, in that group of mothers, as well as for the total of all mothers studied, there were no concomitant improvements in use of early prenatal care, birth weight, or neonatal mortality. Analysis of the timing of enrollment relative to the beginning of pregnancy showed that more than two thirds of the women who enrolled did so after the first trimester.
为了研究1985年田纳西州医疗补助计划监管变化（该变化专门扩大了孕期已婚女性的资格覆盖范围）的影响，我们研究了与医疗补助计划登记文件相关联的人口动态统计文件。就覆盖率的绝对差异和参保女性数量而言，医疗补助覆盖范围增长最大的是教育年限不足12年的25岁以下白人已婚女性，其参保率增长了18%。然而，在该组母亲以及所有研究的母亲群体中，早期产前护理的使用、出生体重或新生儿死亡率并未随之改善。对登记时间相对于怀孕开始时间的分析表明，超过三分之二的参保女性是在孕早期之后参保的。
