Changes in North Carolina maternal health service use and outcomes among medicaid-enrolled pregnant women during state budget cuts

Dorothy Cilenti, Hye Chung Kum, Rebecca Wells, J. Timothy Whitmire, Ravi K. Goyal, Marianne Messersmith Hillemeier

Research output: Contribution to journalArticle

Abstract

OBJECTIVES:: The recent recession has weakened the US health and human service safety net. Questions about implications for mothers and children prompted this study, which tested for changes in maternal service use and outcomes among North Carolina women with deliveries covered through Medicaid before and after a year of significant state budget cuts. METHODS:: Data for Medicaid covered deliveries from April-June 2009 (pre) and from April-June 2010 (post) were derived from birth certificates, Medicaid claims and eligibility files, and WIC (Special Supplemental Food Program for Women, Infants and Children) records. These time periods represent the quarter immediately before as well as the final quarter of a state fiscal year 2010 (July 2009-June 2010) characterized by substantial state budget cuts, including an October 2009 reduction in reimbursement rates for maternity care coordination. We examined how often women received medical care, maternity care coordination, family planning services, and the average numbers of obstetrical encounters, as well as the prevalence of excessive pregnancy weight gain, preterm delivery, and low birth weight. RESULTS:: By the end of a year of substantial state budget cuts, women covered through Medicaid had fewer obstetrical visits in all trimesters as well as postpartum (P < .001). Maternal weight gain, preterm delivery, and low birth weight were stable. CONCLUSIONS:: One key aspect of medical service use decreased for women enrolled in Medicaid by the end of a year of major state health and human services budget cuts. Maternal and infant child health outcomes measured in this study did not change during that year. Future monitoring is warranted to ensure that maternal health service access remains adequate.

Original languageEnglish (US)
Pages (from-to)208-213
Number of pages6
JournalJournal of Public Health Management and Practice
Volume21
Issue number2
DOIs
StatePublished - Feb 6 2015

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Maternal Health Services
Medicaid
Budgets
Pregnant Women
Mothers
Low Birth Weight Infant
Weight Gain
Health Services
Food Assistance
Birth Certificates
Family Planning Services
Postpartum Period
Safety
Food
Pregnancy

All Science Journal Classification (ASJC) codes

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Cilenti, Dorothy ; Kum, Hye Chung ; Wells, Rebecca ; Whitmire, J. Timothy ; Goyal, Ravi K. ; Hillemeier, Marianne Messersmith. / Changes in North Carolina maternal health service use and outcomes among medicaid-enrolled pregnant women during state budget cuts. In: Journal of Public Health Management and Practice. 2015 ; Vol. 21, No. 2. pp. 208-213.
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Changes in North Carolina maternal health service use and outcomes among medicaid-enrolled pregnant women during state budget cuts. / Cilenti, Dorothy; Kum, Hye Chung; Wells, Rebecca; Whitmire, J. Timothy; Goyal, Ravi K.; Hillemeier, Marianne Messersmith.

In: Journal of Public Health Management and Practice, Vol. 21, No. 2, 06.02.2015, p. 208-213.

Research output: Contribution to journalArticle

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