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A Statewide Medicaid Enhanced Prenatal and Postnatal Care Program and Infant Injuries

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Abstract

To compare infant injuries in the first year of life between Maternal Infant Health Program (MIHP) participants and matched comparison groups. The population was the cohort of Medicaid-insured singleton infants born in 2011 in Michigan who had continuous Medicaid insurance and survived the first year after birth (N = 51,078). Propensity score matching was used to compare participants in MIHP to matched comparison groups from among the nonparticipants. Injury episodes were defined based on Medicaid claims in the first year of life. Matched comparisons were performed using McNemar, Bowker, and Wilcoxon signed rank tests to assess the effects of program participation on infant injuries. Infants of MIHP participants were more likely to have injury episodes (11.7 vs. 10.4 %, p < 0.01) and a higher rate of episodes (126.9/1,000 infants vs. 109.6/1,000) compared to matched nonparticipants. Infants of MIHP participants were more likely to have superficial injuries (4.9 vs. 3.9 %, p < 0.01) and a higher rate of episodes related to superficial injuries (49.7/1,000 vs. 39.6/1,000), which mainly accounted for the difference in injury visits between groups. Similar results were found among those enrolled and risk-screened in the program by the 2nd pregnancy trimester and who received a dosage of at least three additional MIHP contacts when compared to matched nonparticipants. MIHP participants did not experience reductions in infant injuries in the first year of life compared to matched nonparticipants. Possible explanations may include increased health-seeking behavior of the mothers participating in MIHP or improved recognition of infant injuries that warrant medical attention.

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References

  1. Avellar, S., & Paulsell, D. (2011). Lessons learned from the home visiting evidence of effectiveness review office of planning, research and evaluation, administration for children and families. Washington, DC: U.S. Department of Health and Human Services. http://homvee.acf.hhs.gov/Lessons_Learned.pdf.

  2. Agency for healthcare research and quality. (2012). 2011 national healthcare disparities report. www.ahrq.gov/research/findings/nhqrdr/nhdr11/index.html.

  3. Blumenshine, P., Egerter, S., Barclay, C. J., Cubbin, C., & Braveman, P. A. (2010). Socioeconomic disparities in adverse birth outcomes: A systematic review. American Journal of Preventive Medicine, 39(3), 263–272.

    Article  PubMed  Google Scholar 

  4. Health Care and Education Affordability Reconciliation Act of 2010. http://www.hhs.gov/healthcare/rights/law/reconciliation-law.pdf.

  5. Iglehart, J. K. (2010). Historic passage—reform at last. New England Journal of Medicine, 362(14), e48.

    Article  CAS  PubMed  Google Scholar 

  6. Paulsell, D., Avellar, S., Sama-Miller, E., Del Grosso, P. (2014). Home visiting evidence of effectiveness review: Executive summary. Washington, DC: Office of planning, research and evaluation, administration for children and families, DHHS. http://homvee.acf.hhs.gov/HomVEE_Executive_Summary_2013.pdf. Accessed on August 8, 2014.

  7. Kitzman, H., Olds, D. L., Henderson, C. R, Jr, Hanks, C., Cole, R., Tatelbaum, R., et al. (1997). Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing. A randomized controlled trial. Journal of the American Medical Association, 278(8), 644–652.

    Article  CAS  PubMed  Google Scholar 

  8. Olds, D. L., Henderson, C. R, Jr, Chamberlin, R., & Tatelbaum, R. (1986). Preventing child abuse and neglect: A randomized trial of nurse home visitation. Pediatrics, 78(1), 65–78.

    CAS  PubMed  Google Scholar 

  9. Campbell, K. I., & Silva, P. A. (1997). Parents as first teachers pilot programme evaluation: Age three assessments. Final report to the ministry of education on the dunedin and Gisborne/East coast areas. Wellington: Ministry of Education.

  10. Wagner, M., Clayton, S., Gerlach-Downie, S., & McElroy, M. (1999). An evaluation of the northern California parents as teachers demonstration. Menlo Park, CA: SRI International.

    Google Scholar 

  11. Matone, M., O’Reilly, A. L., Luan, X., Localio, A. R., & Rubin, D. M. (2012). Emergency department visits and hospitalizations for injuries among infants and children following statewide implementation of a home visitation model. Maternal and Child Health Journal, 16(9), 1754–1761.

    Article  PubMed  Google Scholar 

  12. The Henry Kaiser J. Family Foundation. (2011). Medicaid matters: Understanding Medicaid’s role in our health care system. www.kff.org/medicaid/upload/8165.pdf.

  13. The Annie E. Casey Foundation. (2013). Data center, kids count, Michigan. http://datacenter.kidscount.org/data/bystate/Rankings.aspx?state=MI&ind=1716.

  14. Michigan Department of Community Health. (2010). PRAMS report 2008, Edited by Christin M. Larder and Violanda Grigorescu. http://www.michigan.gov/documents/mdch/MI_PRAMS_2008_Annual_Repot_9_28_2010_340775_7.pdf.

  15. Blumenshine, P., Egerter, S., Barclay, C. J., Cubbin, C., & Braveman, P. A. (2010). Socioeconomic disparities in adverse birth outcomes: A systematic review. American Journal of Preventive Medicine, 39(3), 263–272.

    Article  PubMed  Google Scholar 

  16. Brintnell, D., Peterson-Hickey, M., Stroud, D., Castellano, S., Fogarty, C. The birth certificate and medicaid data match project: Initial findings in infant mortality. http://www.health.state.mn.us/divs/fh/mch/mortality/documents/mortalityfindings.pdf. Accessed on May 29, 2014.

  17. Leventhal, J. M., Martin, K. D., & Gaither, J. R. (2012). Using US data to estimate the incidence of serious physical abuse in children. Pediatrics, 129(3), 458–464. doi:10.1542/peds.2011-1277.

    Article  PubMed  Google Scholar 

  18. Roman, L. A., Raffo, J. E., Zhu, Q., & Meghea, C. I. (2014). A statewide medicaid enhanced prenatal care program: Impact on birth outcomes. JAMA Pediatrics, 168(3), 220–227.

    Article  PubMed  Google Scholar 

  19. Meghea, C. I., Raffo, J. E., Zhu, Q., & Roman, L. (2013). Medicaid home visitation and maternal and infant healthcare utilization. American Journal of Preventive Medicine, 45(4), 441–447.

    Article  PubMed  Google Scholar 

  20. Spady, D. W., Saunders, D. L., Schopflocher, D. P., & Svenson, L. W. (2004). Patterns of injury in children: A population-based approach. Pediatrics, 113(3), 522–529.

    Article  PubMed  Google Scholar 

  21. Lestina, D. C., Miller, T. R., & Smith, G. S. (1998). Creating injury episodes using medical claims data. Journal of Trauma, 45(3), 565–569.

    Article  CAS  PubMed  Google Scholar 

  22. Michigan Department of Community Health. Maternal infant health program (MIHP). http://www.michigan.gov/mdch/0,4612,7-132-2943_4672-106183–,00.html. Accessed on May 9, 2014.

  23. Slaughter, J., Issel, L. M., Handler, A., Rosenberg, D., Kane, D., & Stayner, L. (2013). Measuring dosage: A key factor when assessing the relationship between prenatal case management and birth outcomes. Maternal and Child Health Journal, 17(8), 1414–1423.

    Article  PubMed  Google Scholar 

  24. The Henry Kaiser J. Family Foundation. Medicaid matters: Understanding Medicaid’s role in our health care system. Kaiser Commission on Key Facts. http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8165.pdf. Accessed May 8, 2014.

  25. Rosenbaum, P. R., & Rubin, D. B. (1983). The central role of the propensity score in observational studies for causal effects. Biometrika, 70(1), 41–55.

    Article  Google Scholar 

  26. Rubin, D. B. (1997). Estimating causal effects from large data sets using propensity scores. Annals of Internal Medicine, 127(Part2), 757–763.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This project was supported by a grant from the Michigan Department of Community Health. We thank the Michigan Department of Community Health for facilitating the access to the data.

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The authors report no conflict of interest.

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Correspondence to Cristian I. Meghea.

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Meghea, C.I., You, Z. & Roman, L.A. A Statewide Medicaid Enhanced Prenatal and Postnatal Care Program and Infant Injuries. Matern Child Health J 19, 2119–2127 (2015). https://doi.org/10.1007/s10995-015-1724-z

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