| Doula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries. | |
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MedLine Citation:
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PMID: 23409910 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. (Am J Public Health. Published online ahead of print February 14, 2013: e1-e9. doi:10.2105/AJPH.2012.301201). |
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Authors:
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Katy Backes Kozhimannil; Rachel R Hardeman; Laura B Attanasio; Cori Blauer-Peterson; Michelle O'Brien |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-2-14 |
Journal Detail:
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Title: American journal of public health Volume: - ISSN: 1541-0048 ISO Abbreviation: Am J Public Health Publication Date: 2013 Feb |
Date Detail:
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Created Date: 2013-2-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1254074 Medline TA: Am J Public Health Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Katy Backes Kozhimannil, Rachel R. Hardeman, Laura B. Attanasio, and Cori Blauer-Peterson are with the Division of Health Policy and Management, School of Public Health, and Michelle O'Brien is with the Department of Family Medicine, School of Medicine, University of Minnesota, Minneapolis. Michelle O'Brien is also a family physician in private practice. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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