Well Child Visit Attendance for Group Prenatal Care Participants

Area of Science:

• Maternal and Child Health
• Healthcare Delivery Systems
• Pediatric Care

Background:

• Group prenatal care (GPNC) is known to improve attendance for maternal health visits.
• The impact of GPNC on pediatric care engagement, specifically well-child visit (WCV) attendance, remains less understood.
• Medicaid beneficiaries represent a population where optimizing pediatric care access is crucial.

Purpose of the Study:

• To investigate the association between participation in group prenatal care (GPNC) and well-child visit (WCV) attendance among infants covered by Medicaid.
• To compare WCV attendance rates between infants born to mothers who received GPNC versus individual prenatal care (IPNC).

Main Methods:

• Utilized Medicaid claims and vital statistics from South Carolina (2013-2018).
• Employed propensity-score matching to compare GPNC patients with a matched cohort of IPNC patients.
• Assessed WCV attendance using a Healthcare Effectiveness Data and Information Set (HEDIS) measure: 6 or more WCVs in the first 15 months.

Main Results:

• No significant difference in WCV attendance was found for any GPNC exposure versus IPNC.
• Participation in 5 or more GPNC sessions was associated with a 4.7 percentage point increase in WCV compliance compared to 5+ prenatal visits.
• The positive association between GPNC and WCV attendance was more pronounced for low birthweight infants, Black infants, and infants of mothers with no prior live births.

Conclusions:

• Group prenatal care may have a modest positive influence on well-child visit attendance.
• Further research is needed to understand the mechanisms and dose-response relationship of GPNC on pediatric care engagement.
• Despite potential benefits of GPNC, disparities in WCV attendance compared to benchmarks persist across different prenatal care models.