PRENATAL CARE IN A MANAGED CARE SETTING: PREVENTION OF LOW BIRTH WEIGHT (MINNESOTA, MEDICAID).
Contributors: University of Minnesota.
Published: 1997
Number of pages: 259
Subjects: Health Sciences, Health Care Management.; Health Sciences, Nursing.; Health Sciences, Public Health.
Description: The effects of a prenatal risk assessment form and health plan sponsored nurse care management on infant birth weight were examined in a large Minnesota open-access health maintenance organization (HMO). The content of prenatal care provided by network physicians was also studied to determine its effect on infant birth weight. Important maternal risk factors and the quantitative adequacy of prenatal care were controlled in the statistical analysis. Prenatal care clinical data were obtained from the mother's clinic medical records.

All private and Medicaid funded women in the HMO who delivered a live singleton infant in 1991 were candidates for the study. Factors related to low and normal birthweight groups were compared using chi-square and discriminant analyses. Neither completion of a detailed risk assessment form nor plan sponsored nurse care management were good predictors of infant birth weight group.

In the stepwise analysis, the best predictor of infant birthweight group was the interaction of early initiation of prenatal care and the mother's age. The second and third predictors were receiving recommended routine physical examinations throughout pregnancy and the interaction of recommended physical examinations and comorbid medical conditions.

Based on findings from this study, risk assessment forms are not necessary when routine prenatal physical examinations and assessments are provided according to accepted professional guidelines. The Minnesota Department of Health and the health plan should instead focus on quality assurance activities rather than use of risk assessment forms. The health plan also should assess the role and activities of nurse care managers in the HMO prenatal care program. Plans should monitor provider compliance with professional prenatal care guidelines. Rather than initiating nurse prenatal care management through risk assessment forms, plan nurses should identify and educate members in potential need of prenatal care services through enrollment needs assessment, surveys, newsletters, and the news media.
Notes: Source: Dissertation Abstracts International, Volume: 57-12, Section: B, page: 7435.

Thesis (PH.D.)--UNIVERSITY OF MINNESOTA, 1997.

School code: 0130.