Jp. Kugler et J. Yeash, THE IMPACT OF SOCIODEMOGRAPHIC, HEALTH-CARE SYSTEM, AND FAMILY FUNCTION VARIABLES ON PRENATAL-CARE UTILIZATION IN A MILITARY SETTING, Journal of family practice, 37(2), 1993, pp. 143-147
Background. Appropriate use of prenatal care is associated with more f
avorable perinatal outcomes. This study examines patient characteristi
cs that influence the use of prenatal care in a total reimbursement se
tting. Methods. A cohort analysis was conducted with 368 new obstetric
registrants in a military community hospital. The protocol involved t
he completion of a family function scale and prenatal care survey at t
he onset of care and a record review at the completion of pregnancy. R
esults. Several socioeconomic variables were highly associated with lo
w utilization of prenatal care: low income, difficulty in finding chil
d care, lower educational levels, and difficulty in getting transporta
tion. The method of health care delivery, ie, care in the obstetric cl
inic vs family practice clinic, was also significantly associated with
inadequate utilization. Finally, there appeared to be a negative asso
ciation of cohesion and overall family function scores with the level
of prenatal care use (P < .05). Conclusions. Multiple economic factors
influence the use of prenatal care even in a system with total reimbu
rsement. Family practice care is associated with better utilization pa
tterns; family dysfunction is associated with less prenatal care utili
zation.