| Improving perinatal regionalization for preterm deliveries in a Medicaid covered population: initial impact of the Arkansas ANGELS intervention. | |
| | |
MedLine Citation:
|
PMID: 21413980 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To examine the factors associated with delivery of preterm infants at neonatal intensive care unit (NICU) hospitals in Arkansas during the period 2001-2006, with a focus on the impact of a Medicaid supported intervention, Antenatal and Neonatal Guidelines, Education, and Learning System (ANGELS), that expanded the consulting capacity of the academic medical center's maternal fetal medicine practice. DATA SOURCES: A dataset of linked Medicaid claims and birth certificates for the time period by clustering Medicaid claims by pregnancy episode. Pregnancy episodes were linked to residential county-level demographic and medical resource characteristics. Deliveries occurring before 35 weeks gestation (n=5,150) were used for analysis. STUDY DESIGN: Logistic regression analysis was used to examine time trends and individual, county, and intervention characteristics associated with delivery at hospitals with NICU, and delivery at the academic medical center. PRINCIPAL FINDINGS: Perceived risk, age, education, and prenatal care characteristics of women affected the likelihood of use of the NICU. The perceived availability of local expertise was associated with a lower likelihood that preterm infants would deliver at the NICU. ANGELS did not increase the overall use of NICU, but it did shift some deliveries to the academic setting. CONCLUSION: Perinatal regionalization is the consequence of a complex set of provider and patient decisions, and it is difficult to alter with a voluntary program. |
| | |
Authors:
|
Janet M Bronstein; Songthip Ounpraseuth; Jeffrey Jonkman; Curtis L Lowery; David Fletcher; Richard R Nugent; Richard W Hall |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2011-03-17 |
Journal Detail:
|
Title: Health services research Volume: 46 ISSN: 1475-6773 ISO Abbreviation: Health Serv Res Publication Date: 2011 Aug |
Date Detail:
|
Created Date: 2011-07-06 Completed Date: 2011-09-07 Revised Date: 2013-01-08 |
Medline Journal Info:
|
Nlm Unique ID: 0053006 Medline TA: Health Serv Res Country: United States |
Other Details:
|
Languages: eng Pagination: 1082-103 Citation Subset: IM |
Copyright Information:
|
© Health Research and Educational Trust. |
Affiliation:
|
University of Alabama at Birmingham University of Arkansas for Medical Sciences, Little Rock, AR, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Age Factors Arkansas / epidemiology Female Health Services Accessibility / statistics & numerical data* Health Services Research / statistics & numerical data Humans Infant, Newborn Intensive Care Units, Neonatal / statistics & numerical data* Medicaid / statistics & numerical data* Perinatal Care / statistics & numerical data* Pregnancy Premature Birth / epidemiology* Referral and Consultation / statistics & numerical data Risk Factors Socioeconomic Factors Time Factors United States |
| Grant Support | |
ID/Acronym/Agency:
|
UL1 RR029884/RR/NCRR NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Association between kidney and cardiac diastolic function in Chinese subjects without overt disease:...
Next Document: Does medication adherence lower Medicare spending among beneficiaries with diabetes?