THE IMPACT OF SOCIODEMOGRAPHIC, HEALTH-CARE SYSTEM, AND FAMILY FUNCTION VARIABLES ON PRENATAL-CARE UTILIZATION IN A MILITARY SETTING

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.