爱荷华医疗补助计划中的初级保健病例管理与分娩结局
Primary care case management and birth outcomes in the Iowa Medicaid program.
作者信息
Schulman E D, Sheriff D J, Momany E T
机构信息
University of Kentucky, Lexington 40536-0003, USA.
出版信息
Am J Public Health. 1997 Jan;87(1):80-4. doi: 10.2105/ajph.87.1.80.
OBJECTIVES
This study compares prenatal care utilization and birth outcomes between Iowa Medicaid recipients receiving care in a primary care case management (PCCM) system and those receiving care in a fee-for-service (FFS) system.
METHODS
Birth certificates linked with Medicaid hospitalization claims were analyzed for seven PCCM and seven FFS counties.
RESULTS
From 1989 through 1992, there was (1) a 20% increase in the number of women who received adequate prenatal care in the FFS counties, vs a 5% increase in the PCCM counties; (2) a 17% increase in the number of women who initiated care within the first trimester in the FFS counties, vs a 6% increase in the PCCM counties; and (3) a 442% increase in the number of women who received enhanced prenatal services in the FFS counties, vs a 278% increase in the PCCM counties. There were no significant differences between groups in mean gestational age or birthweight; however, there was an increase of very-low-birthweight babies in both groups.
CONCLUSIONS
PCCM, as implemented by the Iowa Medicaid program, has not appreciably improved prenatal care utilization or birth outcomes.
目的
本研究比较了在初级保健病例管理（PCCM）系统中接受护理的爱荷华州医疗补助受助者与在按服务收费（FFS）系统中接受护理的受助者之间的产前护理利用情况和出生结局。
方法
对七个PCCM县和七个FFS县与医疗补助住院理赔相关联的出生证明进行了分析。
结果
从1989年到1992年，（1）FFS县中接受充分产前护理的女性人数增加了20%，而PCCM县增加了5%；（2）FFS县中在孕早期开始接受护理的女性人数增加了17%，而PCCM县增加了6%；（3）FFS县中接受强化产前服务的女性人数增加了442%，而PCCM县增加了278%。两组之间的平均孕周或出生体重没有显著差异；然而，两组中极低出生体重婴儿的数量都有所增加。
结论
爱荷华州医疗补助计划实施的PCCM并未显著改善产前护理利用情况或出生结局。
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