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Weighing costs and benefits of adequate prenatal care for 12,023 births in Missouri's Medicaid program, 1988.
  • Published Date:
    1992 Nov-Dec
  • Source:
    Public Health Rep. 107(6):647-652
  • Language:
    English
Filetype[PDF-1.17 MB]


Details:
  • Alternative Title:
    Public Health Rep
  • Personal Author:
    Schramm, W F
  • Description:
    Numerous studies have shown that the receipt of adequate prenatal care is associated with improvements in pregnancy outcome, particularly a reduction in the risk of low birth weight. Since medical costs for these low birth weight infants are several times higher than for normal birth weight infants, one would expect that medical costs for newborns would be lower for babies whose mothers have had adequate prenatal care than for those with inadequate prenatal care. Explored in this paper is whether the reduction in Medicaid costs for newborn and post-partum maternal care is greater than the increase in prenatal costs for a Medicaid population. The analysis used a file of 12,023 Missouri Medicaid records linked with the corresponding 1988 birth certificates. A modified version of the Kessner index was used to define the adequacy of prenatal care. Prenatal care costs were $233 higher for pregnancies with adequate prenatal care than for those in which prenatal care was inadequate. Newborn and post-partum costs starting within 60 days after the birth were $347 lower for the adequate prenatal care pregnancies, resulting in a savings of $1.49 for each extra $1 spent on prenatal care. Among the other factors studied in determining this benefit to cost ratio were global billing, Supplemental Food Program for Women, Infants, and Children (WIC), and participation in Medicaid under the expanded eligibility provisions that were effective in Missouri in 1988.
  • Subject:
  • Pubmed ID:
    1454976
  • Pubmed Central ID:
    PMCnull
  • Document Type:
    Journal Article
  • Collection(s):
    Public Health Reports
  • Main Document Checksum:
  • Supporting Files:
    No Additional Files
    1. Social and cultural factors in the successful control of tuberculosis.
      Personal Author:
      Rubel, A J; Garro, L C;
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):626-636
      Description:
      The burden of tuberculosis on the public health is staggering. Worldwide, annual incidence of new cases is estimated to be about 8 million. Almost 3 million deaths occur yearly. Early case identification and adherence to treatment regimens are the re...
      File Type:
      Filetype[PDF - 2.18 MB]
    2. PUBLIC HEALTH PROGRAMS AND PRACTICES
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):736-744
      File Type:
      Filetype[PDF - 1.54 MB]
    3. Estimating the prevalence of mental disorders in U.S. adults from the Epidemiologic Catchment Area Survey.
      Personal Author:
      Bourdon, K H; Rae, D S; Locke, B Z; Narrow, W E; Regier, D A;
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):663-668
      Description:
      The National Institute of Mental Health Epidemiologic Catchment Area Survey is a comprehensive, community-based survey of mental disorders and use of services by adults, ages 18 and older. Diagnoses are based on the criteria in the "Diagnostic and St...
      File Type:
      Filetype[PDF - 1.11 MB]
    4. Group counseling at STD clinics to promote use of condoms.
      Personal Author:
      Cohen, D A; MacKinnon, D P; Dent, C; Mason, H R; Sullivan, E;
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):727-731
      Description:
      An intervention was developed to promote safer sex and condom use among patients seeking treatment for sexually transmitted disease (STD) at a public health STD clinic in Los Angeles, CA. The intervention consisted of a short group discussion on cond...
      File Type:
      Filetype[PDF - 853.67 KB]
    5. Czechoslovakia's changing health care system.
      Personal Author:
      Raffel, M W; Raffel, N K;
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):636-643
      Description:
      Before World War II, Czechoslovakia was among the most developed European countries with an excellent health care system. After the Communist coup d'etat in 1948, the country was forced to adapt its existing health care system to the Soviet model. It...
      File Type:
      Filetype[PDF - 1.36 MB]
    6. Area-level predictors of use of prenatal care in diverse populations.
      Personal Author:
      Kieffer, E; Alexander, G R; Mor, J;
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):653-658
      Description:
      Patterns and predictors of the use of prenatal care in Hawaii were examined by census tract, taking into account summary measures of socioeconomic status, environmental conditions, and aggregated indicators of pregnancy-related risk characteristics o...
      File Type:
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    7. Development and supermarket field testing of videotaped nutrition messages for cancer risk reduction.
      Personal Author:
      Cotugna, N; Vickery, C E;
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):691-694
      Description:
      This article describes the development and field testing of five 1-minute videotaped nutrition public service announcements focusing on the role of nutrition in reducing cancer risks. Topics include dietary fat, vitamin A, vitamin C, cruciferous vege...
      File Type:
      Filetype[PDF - 678.69 KB]
    8. Vitamin supplement use and its correlates among elderly Japanese men residing on Oahu, HI.
      Personal Author:
      Kato, I; Nomura, A M; Stemmermann, G N; Chyou, P H;
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):712-717
      Description:
      Use of vitamin supplements and the association with personal characteristics were investigated among 4,654 American men of Japanese ancestry in Hawaii. A total of 58 percent of the subjects who were ages 68 to 90 took vitamin supplements. Among suppl...
      File Type:
      Filetype[PDF - 1.17 MB]
    9. The FPbase microcomputer system for managing community health screening and intervention data bases.
      Personal Author:
      Assaf, A R; Banspach, S W; Lasater, T M; Ramsey, J; Tidwell, R J; Carleton, R A;
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):695-700
      Description:
      Health promotion and intervention projects at State and community levels need computerized data bases to assist in making policy decisions and in operating the projects. Computer data base systems are used in entering, storing, retrieving, and analyz...
      File Type:
      Filetype[PDF - 1.16 MB]
    10. Breast cancer beliefs of women participating in a television-promoted mammography screening project.
      Personal Author:
      Fuller, S M; McDermott, R J; Roetzheim, R G; Marty, P J;
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):682-690
      Description:
      A survey of breast cancer and breast cancer screening beliefs was mailed to a random sample of 1,000 women who contacted a telephone bank in response to a television-promoted, reduced-cost mammography project. Beliefs and demographics of women in the...
      File Type:
      Filetype[PDF - 1.73 MB]
    11. Maternal pregravid weight, age, and smoking status as risk factors for low birth weight births.
      Personal Author:
      Nandi, C; Nelson, M R;
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):658-662
      Description:
      The Illinois Department of Public Health, in cooperation with the Centers for Disease Control (CDC), monitors trends in the prevalence of prenatal risk factors that are major predictors of infant mortality and low birth weight (LBW). Analyzed data fr...
      File Type:
      Filetype[PDF - 817.54 KB]
    12. An evaluation of the Vermont worksite smoking law.
      Personal Author:
      Paulozzi, L J; Spengler, R F; Gower, M A;
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):724-726
      Description:
      In view of the fact that the impact of statewide smoking laws on private worksite policies and the smoking behavior of employees has not been evaluated, two cross-sectional surveys were performed in Vermont to measure compliance with such a law: a ra...
      File Type:
      Filetype[PDF - 520.40 KB]
    13. Needle sharing and participation in the Amsterdam Syringe Exchange program among HIV-seronegative injecting drug users.
      Personal Author:
      Hartgers, C; van Ameijden, E J; van den Hoek, J A; Coutinho, R A;
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):675-681
      Description:
      To enhance the prevention of human immunodeficiency virus infection, factors related to regular participation in the Amsterdam Syringe Exchange and the borrowing of syringes were studied in 131 HIV-seronegative injecting drug users in a 1989-90 surve...
      File Type:
      Filetype[PDF - 1.24 MB]
    14. Public Health Rep ; v. 107, no. 6 : Masthead
      Published Date:
      Nov-Dec 1992
      Source:
      Public Health Rep. 107(6)
      File Type:
      Filetype[PDF - 4.81 MB]
    15. NATIONAL CENTER FOR HEALTH STATISTICS DATA LINE
      Published Date:
      Nov 1992
      Source:
      Public Health Rep. 107(6):734-735
      File Type:
      Filetype[PDF - 405.87 KB]
    16. AIDS education for health care professionals in an organizational or systems context.
      Personal Author:
      Dworkin, J
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):668-674
      Description:
      Traditionally, health education for practicing health professionals, as well as members of the public, focuses on the individual and relies on changing personal behavior. However, health care for persons with acquired immunodeficiency syndrome (AIDS)...
      File Type:
      Filetype[PDF - 1.46 MB]
    17. Survey of graduates of the Epidemic Intelligence Service as an approach to enhancing ethnic diversity among the nation's epidemiologists.
      Personal Author:
      Thacker, Stephen B.; Mayberry, Robert M.; Herndon, Joy L.; Warren, Rueben C.;
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):718-723
      Description:
      A survey was conducted to improve the recruitment, training, and retention of epidemiologists in the Epidemic Intelligence Service (EIS) Program of the Centers for Disease Control. The authors compared minority graduates of the program and nonminorit...
      File Type:
      Filetype[PDF - 1.29 MB]
    18. The multidrug-resistant tuberculosis challenge to public health efforts to control tuberculosis.
      Personal Author:
      Villarino, Margarita E.; Geiter, Lawrence J.; Simone, Patricia M.;
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):616-625
      Description:
      After years of steady decline, there has been an unprecedented resurgence of tuberculosis (TB) in the United States and outbreaks of multidrug-resistant tuberculosis (MDR-TB). The authors assess the nature, epidemiology, and implications of MDR-TB; p...
      File Type:
      Filetype[PDF - 1.99 MB]
    19. Strengthening the public health system.
      Personal Author:
      Roper, William L.; Baker, Edward L.; Dyal William W.; Nicola, Ray W.;
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):609-615
      Description:
      Although the American public health system has made major contributions to life expectancy for residents of this country over the past century, the system now faces more complex health problems that require comprehensive approaches and increased capa...
      File Type:
      Filetype[PDF - 1.49 MB]
    20. National survey of state epidemiologists to determine the status of Lyme disease surveillance.
      Personal Author:
      Vogt, Richard L.
      Conference Authors:
      International Conference on Lyme Borreliosis (5th : May 30-June 2, 1992 : Arlington, VA)
      Published Date:
      1992 Nov-Dec
      Source:
      Public Health Rep. 107(6):644-646
      Description:
      In 1990, the Council of State and Territorial Epidemiologists and the Centers for Disease Control made Lyme disease (LD) nationally notifiable and developed a national case definition. State epidemiologists were surveyed about their State LD surveill...
      File Type:
      Filetype[PDF - 529.72 KB]
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