The Effect of Providing Health Coverage to Poor Uninsured Pregnant Women in Massachusetts

摘要: Objectives. —There has been substantial policy interest in whether the provision of health coverage to poor uninsured pregnant women affects access prenatal care and birth outcomes. We therefore examined statewide low-income infant Design. —Natural experiment. Patients. —All inhospital, single-gestation live births 1984 (N=57257) 1987 (N=64 346). Intervention. —In 1985, Massachusetts instituted Healthy Start, a program providing with incomes below 185% federal poverty level. Main Outcome Measures. —Rates satisfactory care, initiated before third trimester, adverse outcome for two concurrent control groups, Medicaid, private insurance. calculated difference rates between each control. To assess effect program, we change these interpayer differences 1987. Results. —Between 1987, rate declined from 96.4% 93.8% all ( P Conclusions. —Our findings suggest that may have In setting this decline access, expansion was not associated an improvement or JAMA . 1993;269:87-91)