Abstract:
OBJECTIVES:We compared childbirth-related outcomes for Medicaid recipients who received prenatal education and childbirth support from trained doulas with outcomes from a national sample of similar women and estimated potential cost savings. METHODS:We calculated descriptive statistics for Medicaid-funded births nationally (from the 2009 Nationwide Inpatient Sample; n = 279,008) and births supported by doula care (n = 1079) in Minneapolis, Minnesota, in 2010 to 2012; used multivariate regression to estimate impacts of doula care; and modeled potential cost savings associated with reductions in cesarean delivery for doula-supported births. RESULTS:The cesarean rate was 22.3% among doula-supported births and 31.5% among Medicaid beneficiaries nationally. The corresponding preterm birth rates were 6.1% and 7.3%, respectively. After control for clinical and sociodemographic factors, odds of cesarean delivery were 40.9% lower for doula-supported births (adjusted odds ratio = 0.59; P < .001). Potential cost savings to Medicaid programs associated with such cesarean rate reductions are substantial but depend on states' reimbursement rates, birth volume, and current cesarean rates. CONCLUSIONS:State Medicaid programs should consider offering coverage for birth doulas to realize potential cost savings associated with reduced cesarean rates.
journal_name
Am J Public Healthjournal_title
American journal of public healthauthors
Kozhimannil KB,Hardeman RR,Attanasio LB,Blauer-Peterson C,O'Brien Mdoi
10.2105/AJPH.2012.301201subject
Has Abstractpub_date
2013-04-01 00:00:00pages
e113-21issue
4eissn
0090-0036issn
1541-0048journal_volume
103pub_type
杂志文章abstract::Ischemic heart disease (IHD) mortality of Connecticut firemen and policemen is studied for the years 1960-78, using death certificate data. The mortality of these two occupations is expected to be greater than that of other workers. Standardized Mortality Odds Ratios for firemen and policemen are greater than 1.00. Al...
journal_title:American journal of public health
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journal_title:American journal of public health
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更新日期:2006-09-01 00:00:00
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更新日期:2011-06-01 00:00:00
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更新日期:1997-10-01 00:00:00