The effects of insurance coverage on the quality of prenatal care

1997 ◽  
Vol 6 (6) ◽  
pp. 557-566 ◽  
Author(s):  
M. S. Klinkman
Keyword(s):  
Prenatal Care ◽  
Insurance Coverage

scholarly journals Pain and Hardship Among Older Men: Examining the Buffering Effect of Medicare Insurance Coverage

2018 ◽  
Vol 12 (5) ◽  
pp. 1439-1449 ◽  
Author(s):  
Gillian L. Marshall ◽  
Tamara A. Baker ◽  
Chiho Song ◽  
David B. Miller
Keyword(s):  
Insurance Coverage ◽  
Interactive Effect ◽  
Later Life ◽  
Older Men ◽  
The United States ◽  
Pain Severity ◽  
Financial Strain ◽  
Cross Sectional ◽  
Retirement Study

To better understand the health status of men in the United States, this study aimed to assess the association of hardship on the presence of and pain severity among men 50 years of age and older. Cross-sectional multivariate logistic regression analyses were conducted using the 2010 wave of the Health and Retirement Study ( N = 3,174) to assess the association between four hardship indicators and the presence of pain and pain severity among this sample of older men. Results suggest that the association between the presence of pain and hardship was statistically significant across all four indicators: ongoing financial hardship (CI [1.05, 1.63], p < .05), difficulty paying bills (CI [1.42, 3.02], p < .001), food insecurity (CI [1.46, 3.15], p < .001), and not taking medication due to cost (CI [1.06, 1.66], p < .05), even after adjusting for all demographic factors. The associations between pain severity and ongoing financial strain (CI [1.23, 2.83], p < .01) and difficulty paying bills (CI [1.02, 3.18], p < .05) were statistically significant. Results also indicate that education was a buffer at all levels. In addition, the interactive effect of hardship and Medicare insurance coverage on pain severity was significant only for ongoing financial strain (CI [1.74, 14.33], p > .001) and difficulty paying bills (CI [1.26, 7.05], p < .05). The evidence is clear that each hardship indicators is associated with the presence of pain and across some of the indicators in pain severity among men aged 50 and older. In addition, these findings stress the importance that Medicare insurance plays in acting as a buffer to alleviate some of the hardships experienced by older men. These findings also highlight the association between the presence of pain and pain severity for the overall quality of life, health outcomes, and financial position of men in later life.

Evaluation of New York State's Child Health Plus: Children Who Have Asthma

PEDIATRICS ◽  
2000 ◽  
Vol 105 (Supplement_E1) ◽  
pp. 719-727 ◽  
Author(s):  
Peter G. Szilagyi ◽  
Jane L. Holl ◽  
Lance E. Rodewald ◽  
Lorrie Yoos ◽  
Jack Zwanziger ◽  
...  
Keyword(s):  
Primary Care ◽  
New York ◽  
Quality Of Care ◽  
Health Insurance ◽  
Acute Asthma ◽  
Insurance Coverage ◽  
Asthma Severity ◽  
Asthma Care ◽  
Uninsured Children

Background. Little is known about the impact of providing health insurance to uninsured children who have asthma or other chronic diseases. Objectives. To evaluate the association between health insurance and the utilization of health care and the quality of care among children who have asthma. Design. Before-and-during study of children for a 1-year period before and a 1-year period immediately after enrollment in a state-funded health insurance plan. Intervention. In 1991 New York State implemented Child Health Plus (CHPlus), a health insurance program providing ambulatory and ED (ED), but not hospitalization coverage for children 0 to 12.99 years old whose family incomes were below 222% of the federal poverty level and who were not enrolled in Medicaid. Subjects. A total of 187 children (2–12.99 years old) who had asthma and enrolled in CHPlus between November 1, 1991 and August 1, 1993. Main Outcome Measures. Rates of primary care visits (preventive, acute, asthma-specific), ED visits, hospitalizations, number of specialists seen, and quality of care measures (parent reports of the effect of CHPlus on quality of asthma care, and rates of recommended asthma therapies). The effect of CHPlus was assessed by comparing outcome measures for each child for the year before versus the year after CHPlus enrollment, controlling for age, insurance coverage before CHPlus, and asthma severity. Data Ascertainment. Parent telephone interviews and medical chart reviews at primary care offices, EDs, and public health clinics. Main Results. Visit rates to primary care providers were significantly higher during CHPlus compared with before CHPlus for chronic illness care (.995 visits before CHPlus vs 1.34 visits per year during CHPlus), follow-up visits (.86 visits vs 1.32 visits per year), total visits (5.69 visits vs 7.11 visits per year), and for acute asthma exacerbations (.61 visits vs 0.84 visits per year). There were no significant associations between CHPlus coverage and ED visits or hospitalizations, although specialty utilization increased (30% vs 40%; P = .02). According to parents, CHPlus reduced asthma severity for 55% of children (no change in severity for 44% and worsening severity for 1%). Similarly, CHPlus was reported to have improved overall health status for 45% of children (no change in 53% and worse in 1%), primarily attributable to coverage for office visits and asthma medications. CHPlus was associated with more asthma tune-up visits (48% before CHPlus vs 63% during CHPlus). There was no statistically significant effect of CHPlus on several other quality of care measures such as follow-up after acute exacerbations, receipt of influenza vaccination, or use of bronchodilators or antiinflammatory medications. Conclusions. Health insurance for uninsured children who have asthma helped overcome financial barriers that prevented children from receiving care for acute asthma exacerbations and for chronic asthma care. Health insurance was associated with increased utilization of primary care for asthma and improved parent perception of quality of care and asthma severity, but not with some quality indicators. Although more intensive interventions beyond health insurance are needed to optimize quality of asthma care, health insurance coverage substantially improves the health care for children who have asthma.

scholarly journals Factors associated with the quality of prenatal care: an approach to premature birth

2015 ◽  
Vol 49 (4) ◽  
pp. 0540-0549 ◽  
Author(s):  
Emiliana Cristina Melo ◽  
Rosana Rosseto de Oliveira ◽  
Thais Aidar de Freitas Mathias
Keyword(s):  
Prenatal Care ◽  
Skin Color ◽  
Unplanned Pregnancy ◽  
Univariate Analysis ◽  
Evaluation Criteria ◽  
Care Quality ◽  
White Skin ◽  
Factors Associated ◽  
Term Births

OBJECTIVETo assess the quality of prenatal care in mothers with premature and term births and identify maternal and gestational factors associated with inadequate prenatal care.METHODCross-sectional study collecting data with the pregnant card, hospital records and interviews with mothers living in Maringa-PR. Data were collected from 576 mothers and their born alive infants who were attended in the public service from October 2013 to February 2014, using three different evaluation criteria. The association of prenatal care quality with prematurity was performed by univariate analysis and occurred only at Kessner criteria (CI=1.79;8.02).RESULTSThe indicators that contributed most to the inadequacy of prenatal care were tests of hemoglobin, urine, and fetal presentation. After logistic regression analysis, maternal and gestational variables associated to inadequate prenatal care were combined prenatal (CI=2.93;11.09), non-white skin color (CI=1.11;2.51); unplanned pregnancy (CI=1.34;3.17) and multiparity (CI=1.17;4.03).CONCLUSIONPrenatal care must follow the minimum recommended protocols, more attention is required to black and brown women, multiparous and with unplanned pregnancies to prevent preterm birth and maternal and child morbimortality.

Tell Me What you Mean by “Sí”: Perceptions of Quality of Prenatal Care among Immigrant Latina Women

2001 ◽  
Vol 11 (6) ◽  
pp. 780-794 ◽  
Author(s):  
Deborah E. Bender ◽  
Catherine Harbour ◽  
John Thorp ◽  
Peter Morris
Keyword(s):  
Prenatal Care ◽  
Latina Women

scholarly journals The expression of vulnerability through infant mortality in the municipality of Embu

2008 ◽  
Vol 126 (5) ◽  
pp. 262-268 ◽  
Author(s):  
Renato Nabas Ventura ◽  
Rosana Fiorini Puccini ◽  
Nilza Nunes da Silva ◽  
Edina Mariko Koga da Silva ◽  
Eleonora Menicucci de Oliveira
Keyword(s):  
Infant Mortality ◽  
Prenatal Care ◽  
Care Delivery ◽  
Healthcare Access ◽  
Secondary Data ◽  
Healthcare Services ◽  
Primary Data ◽  
Access To Health Services ◽  
One Year

CONTEXT AND OBJECTIVE: Infant mortality expresses a set of living, working and healthcare access conditions and opens up possibilities for adopting interventions to expand equity in healthcare. This study aimed to investigate vulnerability and the consequent differences in access to health services and occurrences of deaths among infants under one year of age in the municipality of Embu. DESIGN AND SETTING: This was a descriptive study in the municipality of Embu. METHODS: Primary data were collected through interviews with the families of children living in the municipality of Embu who died in the years 1996 and 1997 before reaching one year of age. Secondary data were obtained from death certificates. The variables collected related to living conditions, income, occupation, prenatal care, delivery and the healthcare provided for children. These data were compared with the results obtained from a study carried out in 1996. RESULTS: Statistically significant differences were found with regard to income, working without a formal employment contract and access to private health plans among the families of the children who died. There were also differences in access to and quality of prenatal care, frequency of low birth weight and neonatal intercurrences. CONCLUSIONS: The employment/unemployment situation was decisive in determining the degree of family stability and vulnerability to the occurrence of infant deaths, in addition to the conditions of access to and quality of healthcare services.

Modular Prosthetic Design for Transtibial Child Amputees

2017 ◽  
Author(s):  
Brendan M. Hickey ◽  
Samuel T. Woo ◽  
Sally F. Shady
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Lower Limb ◽  
State Of The Art ◽  
Insurance Coverage ◽  
Review Article ◽  
Prosthetic Design ◽  
Current State ◽  
Limb Deficiencies

Lower limb deficiencies and below knee amputations are the most common form of deficiency that may arise from disease or trauma, and returning a patient close to a normal quality-of-life requires prosthetics, which can be quite challenging. Children present even further difficulty to prosthetists and physicians than adults. Although the underlying prosthetic principles for adults are the same for children, additional considerations must be made for practicality, such as downsizing while maintaining its degree of complexity, and frequent appointments to account for the rapid growth of an adolescent. This review article will evaluate the current state-of-the-art in the field of transtibial-amputee prosthetics, review the insurance coverage a typical family would face, and suggest potential improvements to children’s biomimetic prostheses that aid in reducing the frequency of health care provider intervention.

scholarly journals Opportunities for Outpatient Pharmacy Services for Patients with Cystic Fibrosis: Perceptions of Healthcare Team Members

Pharmacy ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 34 ◽  
Author(s):  
Olufunmilola Abraham ◽  
Ashley Morris
Keyword(s):  
Cystic Fibrosis ◽  
Quality Of Care ◽  
Systems Engineering ◽  
Insurance Coverage ◽  
Multidisciplinary Care ◽  
Care Team ◽  
Healthcare Team ◽  
Care Needs ◽  
Treatment Regimens

Cystic fibrosis (CF) is one of the most common life-threatening, genetic conditions. People with CF follow complex, time-consuming treatment regimens to manage their chronic condition. Due to the complexity of the disease, multidisciplinary care from CF Foundation (CFF)-accredited centers is recommended for people with CF. These centers include several types of healthcare professionals specializing in CF; however, pharmacists are not required members. The purpose of this study was to identify the outpatient care needs of people living with CF that pharmacists could address to improve their quality of care. Healthcare members from a CFF accredited center and pharmacists were recruited to participate in semi-structured, audio-recorded interviews. Prevalent codes were identified and data analysis was conducted, guided by the systems engineering initiative for patient safety (SEIPS) model. The objective was to understand the medication and pharmacy-related needs of patients with CF and care team perspectives on pharmacists providing support for these patients. From the themes that emerged, pharmacists can provide support for people living with CF (medication burden, medication access, medication education) and the CF care team (drug monitoring and adherence, prior authorizations and insurance coverage, refill history). Pharmacists are well-positioned to address these difficulties to improve quality of care for people living with cystic fibrosis.

scholarly journals PDB85 IMPACT OF TYPE OF INSURANCE COVERAGE ON QUALITY OF DIABETES CARE

2019 ◽  
Vol 22 ◽  
pp. S154-S155
Author(s):  
K. Ezendu ◽  
A.A. Ali ◽  
K. Diaby
Keyword(s):  
Diabetes Care ◽  
Insurance Coverage ◽  
Quality Of Diabetes Care

scholarly journals Quality of prenatal care questionnaire: instrument development and testing

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Maureen I Heaman ◽  
Wendy A Sword ◽  
Noori Akhtar-Danesh ◽  
Amanda Bradford ◽  
Suzanne Tough ◽  
...  
Keyword(s):  
Prenatal Care ◽  
Instrument Development
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