Delivery Complications Associated With Prenatal Care Access for Medicaid-Insured Mothers in Rural and Urban Hospitals

Autor/inn/en	Laditka, Sarah B.; Laditka, James N.; Bennett, Kevin J.; Probst, Janice C.
Titel	Delivery Complications Associated With Prenatal Care Access for Medicaid-Insured Mothers in Rural and Urban Hospitals
Quelle	In: Journal of Rural Health, 21 (2005) 2, S.158-166 (9 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0890-765X
DOI	10.1111/j.1748-0361.2005.tb00076.x
Schlagwörter	African Americans; Access to Health Care; Whites; Rural Areas; Risk; Prenatal Care; Pregnancy; Mothers; Hospitals; Ethnicity; United States + Suchen Sie Ihr Suchwort? Afroamerikaner; White; Weißer; Rural area; Ländlicher Raum; Risiko; Pränatale Versorgung; Schwangerschaft; Mother; Mutter; Krankengymnast; Krankenhaus; Ethnizität; USA
Abstract	Pregnancy complications affect many women. It is likely that some complications can be avoided through routine primary and prenatal care of reasonable quality. The authors examined access to health care during pregnancy for mothers insured by Medicaid. The access indicator is potentially avoidable maternity complications (PAMCs). Potentially avoidable maternity complications are often preventable through routine prenatal care, such as infection screening and treatment. The authors examined the risks of potentially avoidable maternity complications among rural and urban hospital deliveries for groups of mothers defined by race or ethnicity. Data are from the year 2000 Nationwide Inpatient Sample (NIS). The stratified sample represents all discharges from 20.5% of community hospitals in the United States. The Nationwide Inpatient Sample identifies hospital locations, but not patients areas of residence. Analyses, which accounted for the sample design, included calculation of potentially avoidable maternity complication rates by race or ethnicity, x-squared, t tests, and multivariate logistic regression. Within groups defined by race or ethnicity, unadjusted rates for potentially avoidable maternity complications did not differ significantly by hospital location. Holding other factors constant, potentially avoidable maternity complications were less common in rural hospitals than in urban hospitals (odds ratio, 0.78; CI, 0.62 to 0.99). In rural hospitals, African Americans had notably higher risk for potentially avoidable maternity complications than did non-Hispanic whites (odds ratio, 1.72; CI, 1.26 to 2.36). In urban hospitals, risk of potentially avoidable maternity complications was not significantly higher for African Americans. Hispanics and Asians had notably lower risks of potentially avoidable maternity complications in urban hospitals than did non-Hispanic whites. Providers and policymakers should work to reisks of potentially avoidable maternity complications for African American women in rural areas who are insured by Medicaid. (Author).
Anmerkungen	National Rural Health Association,One West Armour Blvd, Suite 203, Kansas City, Missouri, 64111-2087. Tel: 816-756-3140; Fax: 816-756-3144
Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10