Pregnancy Medical Home Care Pathways Improve Quality of Perinatal Care and Birth Outcomes

Berrien, Kate; Ollendorff, Arthur; Menard, M. Kathryn

doi:10.18043/ncm.76.4.263

Cited by 11 publications

(10 citation statements)

References 1 publication

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“…Furthermore, as the national emphasis on integrated, patient-centered care grows, navigators may play a central role in pregnancy medical homes, an obstetric variation on patient-centered medical homes. 40…”

Section: Specific Roles For Navigators In Women’s Healthmentioning

confidence: 99%

Patient navigation across the spectrum of women’s health care in the United States

McKenney

Martinez

Yee

2018

American Journal of Obstetrics and Gynecology

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Patient navigation is a patient-centered intervention that uses trained personnel to identify patient-level barriers, including financial, cultural, logistical, and educational obstacles to health care and then mitigate these barriers to facilitate complete and timely access to health services. For example, to assist a woman with Medicaid who is seeking postpartum care, a patient navigator could help her schedule an appointment before her insurance benefits change, coordinate transportation and child care, give her informational pamphlets on contraception options, and accompany her to the appointment to ensure her questions are answered. Existing studies examining the efficacy of patient navigation interventions show particularly striking benefits in the realm of cancer care, including gynecological oncology; patient navigation has been demonstrated to increase access to screening, shorten time to diagnostic resolution, and improve cancer outcomes, particularly in health disparity populations, such as women of color, rural populations, and poor women. Because of the successes in cancer care at reducing disparities in health care access and health outcomes, patient navigation has the potential to improve care and reduce disparities in obstetric and benign gynecological care. We review the concept of patient navigation, offer potential roles for patient navigation in obstetrics and gynecology, and discuss areas for further investigation.

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Section: Specific Roles For Navigators In Women’s Healthmentioning

confidence: 99%

Patient navigation across the spectrum of women’s health care in the United States

McKenney

Martinez

Yee

2018

American Journal of Obstetrics and Gynecology

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“…The term Pregnancy Medical Home has been used to describe community-based care for pregnant women in North Carolina (NC). It has emerged as an effective model for care coordination among pregnant women who are covered by the NC Medicaid program [9,10]. It started in 2011 and has expanded to 94 of North Carolina's 100 counties.…”

Section: Introductionmentioning

confidence: 99%

County‐level correlates of dental service utilization for low income pregnant women. Ecologic study of the North Carolina Medicaid for Pregnant Women (MPW) program

Moss

Grodner

Dasanayake

et al. 2021

BMC Health Serv Res

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Background Dental care utilization for low income pregnant women is met with challenges in the traditional dentist-centered model of care. County-level measures provide insights for policy and roles for stakeholders that extend beyond the dentist-patient relationship. We examined county-level data to generate hypotheses about factors that influence utilization of dental services in North Carolina’s Medicaid for Pregnant Women (MPW) program. Methods County-level Medicaid utilization data for dental services for 2014–2016 were pooled to get mean county estimates of dental utilization in the MPW program. Descriptive statistics and multivariate regression models of dental utilization and county-level measures are presented. Data used were collected by NC Child and the Robert Wood Johnson Foundation’s County Health Rankings Reports. USDA Economic Research Service data were used to categorize counties in terms of Farming, Recreation, Persistent Poverty, and metro/non-metro status using Rural Urban Continuum Codes. Results Dental utilization ranged from 1–26% with a median of 8.5% across the 100 counties of North Carolina. Strong patterns linking utilization of dental services in the MPW program to contextual social measures of well-being emerged, specifically, increased reporting of child abuse and neglect, elevated infant mortality, poor quality of life, and worse ranking in years of potential life lost. Counties with persistent poverty had lower rates of dental utilization. Conclusions Utilization of dental services in the MPW program is generally low. Patterns identify the potential for enhancing community-clinical linkages to improve birth outcomes and care coordination for pregnant women to enhance dental utilization in this population. Dental coverage in the Medicaid program in most states is administered separately from medical coverage. The separation of the funding mechanisms adds a further layer of complexity to care integration. Efforts to enhance dental care for pregnant women in the Medicaid program may benefit from policy that aligns incentives for care coordination within the community. Policy that extends the window of eligibility for dental benefits to 24 months after the birth of the child will help women complete the dental treatment that is needed. This also leverages the value of care coordination for community stakeholders from diverse child health sectors.

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“…The term Pregnancy Medical Home has been used to describe community-based care for pregnant women in North Carolina (NC). It has emerged as an effective model for care coordination among pregnant women who are covered by the NC Medicaid program (Berrien et al 2015;Menard 2017). It started in 2011 and has expanded to 94 of North Carolina's 100 counties.…”

Section: Introductionmentioning

confidence: 99%

County-level Correlates of Dental Service Utilization for Low Income Pregnant Women. Ecologic study of the North Carolina Medicaid for Pregnant Women (MPW) program.

Moss

Grodner

Dasanayake

et al. 2019

Preprint

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Background: Dental care utilization for low income pregnant women is met with challenges in the traditional dentist-centered model of care. County-level measures provide insights for policy and roles for stakeholders that extend beyond the dentist-patient relationship. We examined county-level data to generate hypotheses about factors that influence utilization of dental services in North Carolina’s Medicaid for Pregnant Women (MPW) program. Methods: County-level Medicaid utilization data for dental services for 2014-2016 were pooled to get mean county estimates of dental utilization in the MPW program. Descriptive statistics and multivariate regression models of dental utilization and county-level measures are presented. Data used were collected by NC Child and the Robert Wood Johnson Foundation’s County Health Rankings Reports. USDA Economic Research Service data were used to categorize counties in terms of Farming, Recreation, Persistent Poverty, and metro/non-metro status using Rural Urban Continuum Codes. Results: Dental utilization ranged from 1% to 26% with a median of 8.5% across the 100 counties of North Carolina. Strong patterns linking utilization of dental services in the MPW program to contextual social measures of well-being emerged, specifically, increased reporting of child abuse and neglect, elevated infant mortality, poor quality of life, and worse ranking in years of potential life lost. Counties with persistent poverty had lower rates of dental utilization. Conclusions: Utilization of dental services in the MPW program is generally low. Patterns identify the potential for enhancing community-clinical linkages to improve birth outcomes and care coordination for pregnant women to enhance dental utilization in this population.

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Pregnancy Medical Home Care Pathways Improve Quality of Perinatal Care and Birth Outcomes

Cited by 11 publications

References 1 publication

Patient navigation across the spectrum of women’s health care in the United States

Patient navigation across the spectrum of women’s health care in the United States

County‐level correlates of dental service utilization for low income pregnant women. Ecologic study of the North Carolina Medicaid for Pregnant Women (MPW) program

County-level Correlates of Dental Service Utilization for Low Income Pregnant Women. Ecologic study of the North Carolina Medicaid for Pregnant Women (MPW) program.

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