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Improvements in prenatal insurance coverage and utilization of care in California: an unsung public health victory.
- Source :
-
Maternal & Child Health Journal . Jun2003, Vol. 7 Issue 2, p75-86. 12p. - Publication Year :
- 2003
-
Abstract
- OBJECTIVE: To examine trends in prenatal insurance coverage and utilization of care in California over two decades in the context of expansions in Medi-Cal (California's Medicaid) and other public efforts to increase prenatal care utilization. METHODS: Retrospective univariate and bivariate analysis of prenatal care coverage and utilization data from 10,192,165 California birth certificates, 1980-99; descriptive analysis of California poverty and unemployment data from the U.S. Census Bureau Current Population Survey; review of public health and social policy literature. RESULTS: The proportion of mothers with Medi-Cal coverage for prenatal care increased from 28.2 to 47.5% between 1989 and 1994, and the proportion uninsured throughout pregnancy decreased from 13.2 to 3.2%. Since the mid-1990s, fewer than 3% of women have had no insurance coverage for prenatal care. Between 1989 and 1999, the proportion of women with first trimester initiation of prenatal care increased from 72.6 to 83.6%, reversing the previous decade's trend, and the proportion of women with adequate numbers of visits rose from 70.7 to 83.1%. Improvements in utilization measures were greater among disadvantaged social groups. Improvements in California during the 1990s coincided with a multifaceted public health effort to increase both prenatal care coverage and utilization, and do not appear to be explained by changes in the economy, maternal characteristics, the overall organization/delivery of health care, or other social policies. CONCLUSIONS: While this ecologic study cannot produce definitive conclusions regarding causality, these results suggest an important victory for public health in California. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 10927875
- Volume :
- 7
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Maternal & Child Health Journal
- Publication Type :
- Academic Journal
- Accession number :
- 106869778
- Full Text :
- https://doi.org/10.1023/a:1023812009298