Prenatal Care Satisfaction and Well Baby Checkups by Payor Source

1. Prenatal Care Satisfaction and Well Baby Checkups by Payor Source West Virginia PRAMS Office of Maternal, Child and Family Health Division of Research, Evaluation and Planning Melissa A. Baker, M.A. Coordinator

2. BACKGROUND Early and regular prenatal care are important for the health of both mother and baby. Prenatal care can detect possible problems and in turn begin prevention and or treatment.

3. BACKGROUND Lack of or inadequate prenatal care has been linked with low birth weight, prematurity, infant and maternal mortality.

4. Did payor source make a difference in satisfaction during prenatal care visits?

5. Methods • 2002 and 2003 West Virginia PRAMS data n = 1700 in 2002 with 74% response rate n = 1648 in 2003 with 73% response rate • Variables used Prenatal care payor source Prenatal care satisfaction

6. How was your prenatal care paid for? • Medicaid • Personal income • Health insurance • State Maternal and Child Health Program • Other

7. Prenatal Care Coverage

8. We would like to know how you felt about the prenatal care you got during your most recent pregnancy? Were you satisfied with: • The amount of time you had to wait after you arrived for your visits? • The amount of time the doctor or nurse spent with you during your visits? • The advice you got on how to take care of yourself? • The understanding and respect that the staff showed toward you as a person?

9. Prenatal Care Satisfaction

10. Satisfaction by Payor Source 2002

11. Satisfaction by Payor Source 2003

12. Conclusions • Medicaid coverage accounts for slightly more than half of all prenatal care in West Virginia • Insurance coverage follows closely behind • Overall satisfaction in all areas increased from 2002 to 2003 -Wait time being the lowest of all areas both years

13. Conclusions • There are notable differences in the level of satisfaction based upon payor status: -2002 Other source of payment in all areas of satisfaction -2003 Maternal and Child Health source of payment in all areas of satisfaction -Areas of satisfaction increased from 2002 to 2003 by all payor sources except Other and Maternal and Child Health which both fluctuated between years

14. Public Health Implications Because of the positive health outcomes associated with early prenatal care, it is suggested that all women, regardless of payor source, receive the same time, attention, and information regarding their prenatal care.

15. Did delivery payor source make a difference in well baby checkups?

16. Methods • 2002 and 2003 West Virginia PRAMS data n = 1700 in 2002 with 74% response rate n = 1648 in 2003 with 73% response rate • Variables used Delivery payor source Well baby checkups

17. How was your delivery paid for? • Medicaid • Personal income • Health insurance • State Maternal and Child Health Program • Other

18. Delivery Coverage

19. Has your baby had a well baby checkup?

20. Well Baby Checkups

21. Well baby checkups by delivery payor source

22. Where do you usually take your baby for well baby checkups? • Hospital clinic • Health department clinic • Private doctor’s office • HMO (e.g., Prime One or Care Link) • Other

23. Conclusions • As with prenatal care, Medicaid coverage accounts for slightly more than half of all deliveries in West Virginia • Nearly all infants in West Virginia are receiving well baby checkups regardless of delivery payor source.

24. Public Health Implications Well baby checkups allow the health care provider to monitor an infant’s growth and progress, ensure the infant gets the necessary immunizations, and provide parents with updates as to the infant’s health and development. Based upon the importance of well baby checkups, it is recommended that parents not miss these scheduled appointments.

25. Future Plans PRAMS will continue to be monitored in both areas of prenatal care and well baby checkups and follow up with suggestions as needed.