Department of Health Services, Policy, & Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Department of Health Policy & Management, Columbia University Mailman School of Public Health, New York, New York, USA.
Health Serv Res. 2022 Dec;57(6):1288-1294. doi: 10.1111/1475-6773.14035. Epub 2022 Jul 22.
To assess the association between the adoption of presumptive eligibility for pregnancy Medicaid in Kansas in 2016 and timely prenatal care access.
2012-2019 National Center for Health Statistics natality files.
We used difference-in-differences to compare outcomes before (2012-2015) and after (2017-2019) presumptive eligibility in Kansas relative to seven control group states overall and stratified by maternal education. Outcomes included first-trimester prenatal care, the month of first prenatal visit, and adequate prenatal care.
DATA COLLECTION/EXTRACTION METHODS: All live births among adults aged 20 or older in Kansas, Idaho, Missouri, Nebraska, Tennessee, Utah, Wisconsin, and Wyoming.
Among all births, we found no evidence that presumptive eligibility in Kansas resulted in changes in prenatal care use. Among individuals with high school education or less, presumptive eligibility was associated with a 1.92 percentage-point increase (95% CI: 0.64, 4.35) in first-trimester prenatal care, driven by earlier month of first prenatal care visit.
Presumptive eligibility in Medicaid non-expansion states may lead to small improvements in early prenatal care among individuals with lower education, but other interventions may be needed.
评估 2016 年堪萨斯州采用妊娠医疗补助计划推定资格与及时获得产前护理之间的关联。
2012-2019 年国家卫生统计中心生育档案。
我们使用差分法，将堪萨斯州在推定资格实施前后（2012-2015 年和 2017-2019 年）与七个对照组州的总体结果进行比较，并按产妇教育程度进行分层。结果包括首次孕期护理、首次产前检查的月份以及充分的产前护理。
数据收集/提取方法：堪萨斯州、爱达荷州、密苏里州、内布拉斯加州、田纳西州、犹他州、威斯康星州和怀俄明州 20 岁及以上成年人的所有活产儿。
在所有分娩中，我们没有发现堪萨斯州推定资格的实施导致产前护理使用发生变化的证据。在高中及以下学历的人群中，推定资格与首次孕期护理的提前月份相关，使首次孕期护理增加了 1.92 个百分点（95%CI：0.64，4.35）。
在非扩张医疗补助州采用推定资格可能会使教育程度较低的个体早期产前护理略有改善，但可能需要其他干预措施。
