Related Experiment Video
Updated: Jun 2, 2025
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Preventing Infant Mortality Through Medicaid-Administered Prenatal Care Coordination: Evidence From Wisconsin
David C Mallinson1, Yamikani B Nkhoma-Mussa2, Kate H Gillespie2
1Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Objective:
To estimate associations between Wisconsin Medicaid's Prenatal Care Coordination (PNCC) program and infant mortality.
Data Sources And Study Setting:
We analyzed birth records, Medicaid claims, and infant death records for all resident and in-state Medicaid-paid live deliveries during 2010-2018.
Study Design:
We measured PNCC exposure during pregnancy dichotomously (none; any) and categorically (none; assessment/care plan only; service receipt). Our outcome was infant mortality (death at age < 365 days). Adjusted binary logit regressions and propensity score weighted regressions tested associations between PNCC receipt and infant mortality, and we estimated probabilities and average marginal effects of infant mortality. We also executed regressions with interactions on maternal race/ethnicity to determine if associations varied across Black non-Hispanic (NH), Hispanic, and White NH births.
Data Collection/Extraction Methods:
Our sample consisted of 231,540 Medicaid-paid births during 2010-2018. PNCC is only available to pregnant Medicaid beneficiaries.
Principal Findings:
Infant mortality was lower among PNCC assessment/care plan only births (5.0 deaths/1000 births) and PNCC service receipt births (6.1 deaths/1000 births) relative to non-PNCC births (6.8 deaths/1000 births). This pattern was consistent in Black NH and Hispanic subgroups, but infant mortality did not vary by PNCC among White NH deliveries. Overall, adjusted binary logit regressions indicated that the probabilities of infant mortality were 0.70% for no PNCC and 0.53% for any PNCC, yielding an average marginal effect of -0.17 percentage points (95% confidence interval -0.22 percentage points, -0.11 percentage points). This association did not vary by PNCC exposure level. PNCC-infant mortality associations were significantly stronger for Black NH births relative to White NH births. Results were consistent in propensity score weighted regressions.
Conclusions:
PNCC during pregnancy is associated with a lower probability of infant mortality, particularly in Black NH families. The benefit of PNCC on infant mortality may not depend on receiving services beyond care planning.
More Related Videos
05:04A Common Marmoset Model of Mother-Infant Intervention for Breastfeeding Disorders in the Presence of Paternal Inhibition and Maternal Neglect
Published on: September 22, 2023
08:50A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
Published on: June 24, 2020
Related Concept Videos
01:30Preventive Healthcare Services
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:26Levels of Health Promotion and Illness Prevention
In primary prevention, actions taken before disease onset prevent the disease from...
01:18Introduction To Health Care Delivery System
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:21Planning Nursing Care I