Primary care case management and birth outcomes in the Iowa Medicaid program

E.D. Schulman, D.J. Sheriff and E.T. Momany

American Journal of Public Health, 1997, vol. 87, issue 1, 80-84

Abstract: 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, them 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.

Date: 1997
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:1997:87:1:80-84_7

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