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Quality Care in a Medicaid Managed Care Program: Adequacy of Prenatal Care for Teens in Chicago

Authors

  • Blair D Gifford Ph.D.

    1. Blair D. Gifford is an Associate Professor of Health Administration and Management, Graduate School of Business Administration, University of Colorado, Denver, Colorado.
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Address correspondence to Blair D. Gifford, Associate Professor of Health Administration and Management, Graduate School of Business Administration, University of Colorado, Denver, Campus Box 165, P.O. Box 173364, Denver, CO 80217–3364. E-mail: bgifford@carbon.cudenver.edu

Abstract

This study considers whether obstetricians offer less adequate care to teen prenatal patients in the Healthy Moms, Healthy Kids (HMHK) Medicaid managed care program in Chicago than to non-Medicaid patients. Telephone surveys of obstetricians offices (n= 101) were conducted to determine the content of care in the first prenatal visit. These survey data are combined with demographic and practice background data from The American Medical Association's Physician Master File. Analysis indicates there were no significant differences between groups for receiving: (1) medical histories, (2) physical exam and tests, (3) health promotion counseling, and (4) availability of birthing education materials. Analysis further indicates, however, that teen Medicaid patients are less likely to receive blood tests and some urinalysis-related tests. Not receiving these tests is especially problematic because pregnant teens are more likely to drop out of the prenatal care regimen after their first visit, and teens are more likely to have poorer birth outcomes.

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