TY - JOUR
T1 - Estimating the effect of Prenatal Care Coordination in Wisconsin
T2 - A sibling fixed effects analysis
AU - Mallinson, David C.
AU - Larson, Andrea
AU - Berger, Lawrence M.
AU - Grodsky, Eric
AU - Ehrenthal, Deborah B.
N1 - Funding Information:
Joint Acknowledgments/Disclosure Statement: This work was supported in part by the University of Wisconsin-Madison Clinical and Translational Science Award program through the National Institutes of Health National Center for Advancing Translational Sciences (Grant UL1TR00427), by the University of Wisconsin-Madison School of Medicine and Public Health's Wisconsin Partnership Program, and by the University of Wisconsin-Madison Institutes for Research on Poverty. This content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the University of Wisconsin-Madison School of Medicine and Public Health's Wisconsin Partnership Program, or the Institute for Research on Poverty. We thank Steven T. Cook, Dan Ross, Jane A. Smith, Kristen Voskuil, and Lynn Wimer for data access and programming assistance. We also thank the Wisconsin Department of Children and Families, Department of Health Services, and Department of Workforce Development for the use of data for this analysis, but these agencies do not certify the accuracy of the analyses presented. Disclosures: none.
Funding Information:
Joint Acknowledgements/Disclosure Statement : This work was supported in part by the University of Wisconsin‐Madison Clinical and Translational Science Award program through the National Institutes of Health National Center for Advancing Translational Sciences (Grant UL1TR00427), by the University of Wisconsin‐Madison School of Medicine and Public Health's Wisconsin Partnership Program, and by the University of Wisconsin‐Madison Institutes for Research on Poverty. This content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the University of Wisconsin‐Madison School of Medicine and Public Health's Wisconsin Partnership Program, or the Institute for Research on Poverty. We thank Steven T. Cook, Dan Ross, Jane A. Smith, Kristen Voskuil, and Lynn Wimer for data access and programming assistance. We also thank the Wisconsin Department of Children and Families, Department of Health Services, and Department of Workforce Development for the use of data for this analysis, but these agencies do not certify the accuracy of the analyses presented. Disclosures : none.
Publisher Copyright:
© Health Research and Educational Trust
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Objective: To estimate Prenatal Care Coordination’s (PNCC) effect on birth outcomes for Wisconsin Medicaid-covered deliveries. Data Source: A longitudinal cohort of linked Wisconsin birth records (2008-2012), Medicaid claims, and state-administered social services. Study Design: We defined PNCC treatment dichotomously (none vs. any) and by service level (none vs. assessment/care plan only vs. service uptake). Outcomes were birthweight (grams), low birthweight (<2500 g), gestational age (completed weeks), and preterm birth (<37 weeks). We estimated PNCC′s effect on birth outcomes, adjusting for maternal characteristics, using inverse-probability of treatment weighted and sibling fixed effects regressions. Data Collection/Extraction Methods: We identified 136 224 Medicaid-paid deliveries, of which 33 073 (24.3 percent) linked to any PNCC claim and 22 563 (16.6 percent) linked to claims for PNCC service uptake. Principal Findings: Sibling fixed effects models—which best adjust for unobserved confounding and treatment selection—produced the largest estimates for all outcomes. For example, in these models, PNCC service uptake was associated with a 1.3 percentage point (14 percent) reduction and a 1.8 percentage point (17 percent) reduction in the probabilities of low birthweight and preterm birth, respectively (all P <.05). Conclusions: PNCC′s modest but significant improvement of birth outcomes should motivate stronger PNCC outreach and implementation of similar programs elsewhere.
AB - Objective: To estimate Prenatal Care Coordination’s (PNCC) effect on birth outcomes for Wisconsin Medicaid-covered deliveries. Data Source: A longitudinal cohort of linked Wisconsin birth records (2008-2012), Medicaid claims, and state-administered social services. Study Design: We defined PNCC treatment dichotomously (none vs. any) and by service level (none vs. assessment/care plan only vs. service uptake). Outcomes were birthweight (grams), low birthweight (<2500 g), gestational age (completed weeks), and preterm birth (<37 weeks). We estimated PNCC′s effect on birth outcomes, adjusting for maternal characteristics, using inverse-probability of treatment weighted and sibling fixed effects regressions. Data Collection/Extraction Methods: We identified 136 224 Medicaid-paid deliveries, of which 33 073 (24.3 percent) linked to any PNCC claim and 22 563 (16.6 percent) linked to claims for PNCC service uptake. Principal Findings: Sibling fixed effects models—which best adjust for unobserved confounding and treatment selection—produced the largest estimates for all outcomes. For example, in these models, PNCC service uptake was associated with a 1.3 percentage point (14 percent) reduction and a 1.8 percentage point (17 percent) reduction in the probabilities of low birthweight and preterm birth, respectively (all P <.05). Conclusions: PNCC′s modest but significant improvement of birth outcomes should motivate stronger PNCC outreach and implementation of similar programs elsewhere.
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U2 - 10.1111/1475-6773.13239
DO - 10.1111/1475-6773.13239
M3 - Article
C2 - 31701531
AN - SCOPUS:85074829514
SN - 0017-9124
VL - 55
SP - 82
EP - 93
JO - Health Services Research
JF - Health Services Research
IS - 1
ER -