Piper J M, Mitchel E F, Ray W A
Preventive Medicine Department, Vanderbilt University, Nashville, TN 37232-2637.
Am J Public Health. 1994 Oct;84(10):1626-30. doi: 10.2105/ajph.84.10.1626.
"Presumptive eligibility" permits pregnant prospective Medicaid enrollees to obtain services during the application period. The purpose of this study was to assess the effects of presumptive eligibility on the receipt of prenatal care and the occurrence of low-birthweight births and neonatal, perinatal, and infant mortality.
Outcome rates for pregnant women who enrolled in Tennessee Medicaid in the 6-month period before presumptive eligibility was enacted were compared with those obtained for pregnant women who enrolled in the 6-month period after presumptive eligibility had been in effect for 5 months.
Women in the "after" group were 40% more likely to enroll and 30% more likely to obtain prenatal care in the first trimester. They were 300% more likely to fill a prescription for prenatal vitamins in the first trimester and 16% more likely to have begun prenatal care before the third trimester. However, they were similar to those enrolling in the "before" time period in terms of the occurrence of adverse perinatal outcomes.
When barriers to prenatal care, including bureaucratic ones, are removed, low-income women will seek care earlier and more frequently.
“推定资格”允许预期参加医疗补助计划的孕妇在申请期间获得服务。本研究的目的是评估推定资格对产前护理的接受情况、低体重儿出生以及新生儿、围产期和婴儿死亡率的影响。
将在推定资格颁布前6个月内加入田纳西州医疗补助计划的孕妇的结局发生率与在推定资格生效5个月后的6个月内加入的孕妇的结局发生率进行比较。
“之后”组的女性登记的可能性高40%，在孕早期获得产前护理的可能性高30%。她们在孕早期开具产前维生素处方的可能性高300%，在孕晚期之前开始产前护理的可能性高16%。然而，就不良围产期结局的发生情况而言，她们与“之前”时间段登记参保的女性相似。
当包括官僚障碍在内的产前护理障碍被消除时，低收入女性会更早且更频繁地寻求护理。
