Mason Mattie, Afe Abayomi Joseph, Fransaw Jamesia
New Life Perinatal Health Care Services, Inc., Houston, Texas, USA.
School of Health Sciences, Purdue University Global, Indianapolis, USA.
J Mother Child. 2025 Jul 2;29(1):55-62. doi: 10.34763/jmotherandchild.20252901.d-25-00002. eCollection 2025 Feb 1.
Prenatal care in the US is often mediated through managed care organisations. Other community-based health organisations also implement nurse-led care programs to help pregnant women navigate prenatal care services. The aim of this study is to assess the impact of such organisational services.
This was a retrospective cohort analysis of data generated from providing community-based care management services to pregnant women in Houston, Texas. Clients' characteristics and outcomes were analysed and described.
About 60 pregnant women received care management services between 2022 and 2023. Out of these, 24 (40%) were teenagers (13-19 years of age), 28 (47%) were young adults (20-26 years), 5 (8%) were 27-30 years, and 3 (5%) were older than 35 years. The youngest patient was 15 years old and the oldest was 39 years. 50% (n = 30) were African-American, 38% (n = 23) were Hispanic, and 12% (n = 7) were white. 48% (n = 29) were in their second trimester, 30% (n = 18) were in their first trimester and 22% (n = 13) were in their third trimester. The earliest gestational age was four weeks, the oldest gestational age was 38 weeks, and the average was 20 weeks. The most common medical risk factors were anxiety, depression, and epilepsy. Others included anaemia, diabetes, alcoholism, smoking, PCOS, thalassemia, renal disease, COVID-19 infection, Lupus erythematosus, multiple gestation, and previous miscarriage. Half of the women, n = 27 (46%), had incorrect Medicaid health insurance that did not cover pregnancy care, and the other half, n=32 (54%), had no health insurance at all.
While it took an average of 53 days for the women in this study to get enrolled in a managed care organisation, it only took an average of 22 days for them to attend their first doctor's appointment when care was directly coordinated by a nurse led community-based health organization. This speaks to the efficacy of nurse-led, community-based care management in improving early access to prenatal care.
美国的产前护理通常通过管理式医疗组织进行协调。其他社区卫生组织也实施由护士主导的护理项目，以帮助孕妇获得产前护理服务。本研究旨在评估此类组织服务的影响。
这是一项回顾性队列分析，数据来自于为得克萨斯州休斯顿的孕妇提供基于社区的护理管理服务。对客户的特征和结果进行了分析和描述。
2022年至2023年期间，约60名孕妇接受了护理管理服务。其中，24名（40%）为青少年（13 - 19岁），28名（47%）为年轻人（20 - 26岁），5名（8%）为27 - 30岁，3名（5%）年龄超过35岁。最年轻的患者为15岁，最年长的为39岁。50%（n = 30）为非裔美国人，38%（n = 23）为西班牙裔，12%（n = 7）为白人。48%（n = 29）处于孕中期，30%（n = 18）处于孕早期，22%（n = 13）处于孕晚期。最早的孕周为4周，最晚的孕周为38周，平均孕周为20周。最常见的医疗风险因素为焦虑、抑郁和癫痫。其他因素包括贫血、糖尿病、酗酒、吸烟、多囊卵巢综合征、地中海贫血、肾病、新冠病毒感染、红斑狼疮、多胎妊娠和既往流产史。一半的女性，n = 27（46%），拥有不正确的医疗补助医疗保险，该保险不涵盖孕期护理，另一半，n = 32（54%），根本没有医疗保险。
虽然本研究中的女性平均需要53天才能加入管理式医疗组织，但当由护士主导的社区卫生组织直接协调护理时，她们平均只需22天就能首次就诊。这表明由护士主导的基于社区的护理管理在改善早期获得产前护理方面的有效性。
