Title

Statewide Medicaid Enhanced Prenatal Care Programs and Infant Mortality

Date

2015

Author(s)

Cristian I. Meghea, Zhiying You, Jennifer Raffo, Richard E. Leach, and Lee Anne Roman

Type of Product

Journal Publication

Model(s)

  • Other Models

Description

OBJECTIVE: To evaluate whether participation in a statewide enhanced prenatal and postnatal abstract care program, the Maternal Infant Health Program (MIHP), reduced infant mortality risk. METHODS: Data included birth and death records, Medicaid claims, and program participation. The study population consisted of Medicaid-insured singleton infants born between January 1, 2009, and December 31, 2012, in Michigan (n = 248 059). The MIHP participants were propensity score-matched with nonparticipants based on demographics, previous pregnancies, socioeconomic status, and chronic disease. Infant mortality, neonatal mortality, and postneonatal mortality analyses were presented by race. RESULTS: Infants with any MIHP participation had reduced odds of death in the first year of life compared with matched nonparticipants (odds ratio [OR] 0.73, 95% confidence interval [CI] 0.63–0.84). Infant death odds were reduced both among black infants (OR 0.71, 95% CI 0.58–0.87) and infants of other races (OR 0.74, 95% CI 0.61–0.91). Neonatal death (OR 0.70, 95% CI 0.57–0.86) and postneonatal death odds (OR 0.78, 95% CI 0.63–0.96) were also reduced. Enrollment and screening in MIHP by the end of the second pregnancy trimester and at least 3 additional prenatal MIHP contacts reduced infant mortality odds further (OR 0.70, 95% CI 0.58–0.85; neonatal: OR 0.67, 95% CI 0.51–0.89; postneonatal: OR 0.74, 95% CI 0.56–0.98). CONCLUSIONS: A state Medicaid-sponsored population-based home-visitation program can be a successful approach to reduce mortality risk in a diverse, disadvantaged population. A likely mechanism is the reduction in the risk of adverse birth outcomes, consistent with previous findings on the effects of the program. (author abstract)

Data Collection Methods

  • Program administrative record reviews

Status

Finished

For More Information

Meghea, C. I., You, Z., Raffo, J., Leach, R. E., & Roman, L. A. (2015). Statewide Medicaid enhanced prenatal care programs and infant mortality. Pediatrics, 136(2), 1-11. doi: 10.1542/peds.2015-0479
Author Contact Information:
Cristian I. Meghea
cristian.meghea@hc.msu.edu

Topics

  • Participant, Family, and Program Outcomes