Document Detail


Doula care, birth outcomes, and costs among Medicaid beneficiaries.
MedLine Citation:
PMID:  23409910     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We compared childbirth-related outcomes for Medicaid recipients who received prenatal education and childbirth support from trained doulas with outcomes from a national sample of similar women and estimated potential cost savings.
METHODS: We calculated descriptive statistics for Medicaid-funded births nationally (from the 2009 Nationwide Inpatient Sample; n = 279,008) and births supported by doula care (n = 1079) in Minneapolis, Minnesota, in 2010 to 2012; used multivariate regression to estimate impacts of doula care; and modeled potential cost savings associated with reductions in cesarean delivery for doula-supported births.
RESULTS: The cesarean rate was 22.3% among doula-supported births and 31.5% among Medicaid beneficiaries nationally. The corresponding preterm birth rates were 6.1% and 7.3%, respectively. After control for clinical and sociodemographic factors, odds of cesarean delivery were 40.9% lower for doula-supported births (adjusted odds ratio = 0.59; P < .001). Potential cost savings to Medicaid programs associated with such cesarean rate reductions are substantial but depend on states' reimbursement rates, birth volume, and current cesarean rates.
CONCLUSIONS: State Medicaid programs should consider offering coverage for birth doulas to realize potential cost savings associated with reduced cesarean rates.
Authors:
Katy Backes Kozhimannil; Rachel R Hardeman; Laura B Attanasio; Cori Blauer-Peterson; Michelle O'Brien
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2013-02-14
Journal Detail:
Title:  American journal of public health     Volume:  103     ISSN:  1541-0048     ISO Abbreviation:  Am J Public Health     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-11     Completed Date:  2013-05-16     Revised Date:  2014-04-02    
Medline Journal Info:
Nlm Unique ID:  1254074     Medline TA:  Am J Public Health     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e113-21     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Cesarean Section / economics,  statistics & numerical data*
Clinical Competence
Doulas*
Female
Humans
Infant, Newborn
Infant, Premature
Labor, Obstetric
Logistic Models
Medicaid / economics*
Pregnancy
Pregnancy Outcome*
Prenatal Care / economics
United States
Grant Support
ID/Acronym/Agency:
K12 HD055887/HD/NICHD NIH HHS; K12HD055887/HD/NICHD NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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