OBSTETRIC CARE AND PAYMENT SOURCE - DO LOW-RISK MEDICAID WOMEN GET LESS CARE

Objectives. This study examined whether Medicaid-insured women at low risk receive less adequate obstetricaI care than privately insured wom en. Methods. Low-risk women who were cared for by a random sample of o bstetrical providers in Washington State were randomly selected, Infor mation on all prenatal and intrapartum services was abstracted from me dical records. Service information was aggregated into standardized re source-use units. Results compared Medicaid-insured women with those w ho were privately insured. Results. Medicaid-insured women were signif icantly younger (22.5 years vs 26.9 years) and averaged 6% fewer visit s than privately insured women. Nonetheless, Medicaid status had no me aningful association with prenatal, intrapartum, or overall resource u se. Some variation occurred in individual resources received. Medicaid -insured women had 38.8% more resources expended on testing for sexual ly transmitted diseases. Privately insured women had more resources ex pended on alpha-fetoprotein testing and on amniocentesis. There were n o meaningful differences in birthweight or gestational age at delivery . Conclusions. In this study of women who entered obstetrical care at low risk, similar care and resources were expended on Medicaid-insured and on privately insured women.