Does Maternity Care Coordination Influence Perinatal Health Care Utilization? Evidence from North Carolina
研究评估产妇护理协调对低收入女性围产期医疗利用的影响，发现参与该项目的女性更早开始产前检查、获得更多产前和初级保健，并更可能使用产后服务，但短期医疗支出增加。
OBJECTIVE: To examine effects of maternity care coordination (MCC) on perinatal health care utilization among low-income women. DATA SOURCES: North Carolina Center for Health Statistics Baby Love files that include birth certificates, maternity care coordination records, WIC records, and Medicaid claims. STUDY DESIGN: Causal effects of MCC participation on health care outcomes were estimated in a sample of 7,124 singleton Medicaid-covered births using multiple linear regressions with inverse probability of treatment weighting (IPTW). PRINCIPAL FINDINGS: Maternity care coordination recipients were more likely to receive first-trimester prenatal care (p < .01) and averaged three more prenatal visits and two additional primary care visits during pregnancy; they were also more likely to participate in WIC and to receive postpartum family planning services (p < .01). Medicaid expenditures were greater among mothers receiving MCC. CONCLUSIONS: Maternity care coordination facilitates access to health care and supportive services among Medicaid-covered women. Increased maternal service utilization may increase expenditures in the short run; however, improved newborn health may reduce the need for costly neonatal care, and by implication the need for early intervention and other supports for at-risk children.