Changes in prenatal care timing and low birth weight by race and socioeconomic status: implications for the Medicaid expansions for pregnant women.

摘要: Abstract OBJECTIVE: To conduct the first national study that assesses whether Medicaid expansions for pregnant women, legislated by Congress over a decade ago, met policy objectives of improved access to care and birth outcomes poor near-poor women. DATA SOURCES/STUDY SETTING: Data on 8.1 million births using 1980, 1986, 1993 National Natality Files. We use from all areas United States except California, Texas, Washington, upstate New York. METHODS: before after analysis compares obstetrical race socioeconomic status periods 1980-86 1986-93. examine women low showed greater improvements in during 1986-93 period compared period. analyze two outcomes: rate late initiation prenatal weight. COLLECTION: data were aggregated race, status, age, parity groups. RESULTS: During period, rates decreased 6.0 7.8 percentage points beyond changes estimated both white African American status. For some weight was reduced 0.26 0.37 between 1986 relative earlier Other no improvement CONCLUSIONS: The lead significant utilization among emerging lesson expansions, however, is increased primary not adequate if goal narrow gap newborn health nonpoor populations.