Racial and Geographic Variation of Prenatal Care Coordination Receipt in the State of Wisconsin, 2010 –2019

This study evaluates racial and geographic variation in the receipt of Wisconsin Medicaid’s Prenatal Care Coordination (PNCC) program during 2010–2019. We sample 250,596 Medicaid-paid deliveries from a cohort of linked Wisconsin bi rth records and Medicaid claims. We measure PNCC receipt during pregnancy dichotomously (none; any) and categorically (none; assessment/care plan only; service receipt), and we stratify the sample on three maternal characteristics: race/ethnicity, urbanicity of residence county; and region of reside nce county. We examine annual trends in PNCC uptake and conduct logistic regressions to identify factors associated with assessment or service receipt. Statewide PNCC outreach decreased from 25% in 2010 to 14% in 2019, largely due to the decline in beneficiaries who only receive assessments/care pla ns. PNCC service receipt was greatest and persistent in Black and Hispanic populations and in urban areas. In contrast, PNCC service receipt was relatively low and shrinking in American Indian/Alaska Native, Asian/Pacific Islander, and white populations and in more rural areas. Additionally, being f oreign-born was associated with an increased likelihood of getting a PNCC assessment in Asian/Pacific Islander and Hispanic populations, but we observed the opposite association in Black and white populations. Estimates signal a gap in PNCC receipt among some at-risk populations in Wisconsin, and fi ndings may inform policy to enhance PNCC outreach.
Source: Journal of Community Health - Category: International Medicine & Public Health Source Type: research