(SDAS) Effects of Care Coordination Services on Maternal and Child Health Outcomes
Grantee: Pennsylvania State University
Principal Investigator: Marianne M. Hillemeier
Project Number: R40MC21519
Project Date: 2/1/2011
Final Report
Age group(s)
- Women/Maternal
- Prenatal
- Perinatal/Infancy (0-12 months)
Abstract
Care coordination services, which are activities that help to link mothers and children to an array of healthpromoting resources, avoid duplication of effort, and improve communication between families and providers, have long been endorsed by the public health community, especially for low-income, race/ethnic minority, and geographically isolated populations who experience disproportionately elevated health risks. However, research evidence about the effectiveness of these services is weak and incomplete. The purpose of the proposed project is to systematically examine how care coordination services affect perinatal and early childhood health outcomes. In an era of economic shortfalls and competing priorities, a strong evidence base is essential for promoting effective care coordination that can improve health outcomes and reduce disparities in outcomes among disadvantaged groups. Analyzing a rich array of existing data on pregnant women and infants in North Carolina, and incorporating recent methodological advances in causal modeling in addition to standard regression methods, this research will accomplish the following specific aims: 1. To examine relationships between receipt of care coordination services and health outcomes for women and children, and among women and children receiving care coordination services whether greater quantities of those services are associated with comparatively more favorable health outcomes. 2. To analyze among women and children receiving care coordination services whether characteristics of their provider organizations including infrastructure, caseload size, and caseworker credentials differ by race/ethnicity and rural/urban residence. 3. To examine whether characteristics of the provider organizations including infrastructure, caseload size, and caseworker credentials are associated with health outcomes for women and children receiving care coordination, and whether these associations differ by race/ethnicity and rural/urban residence. The maternal and child outcomes of interest include preterm birth and low birthweight, fetal death, maternal pregnancy weight gain, prenatal care receipt, breastfeeding, family planning services receipt, well child care receipt, emergency department services for child injury or toxic substance ingestion suggestive of child abuse or neglect, and costs of maternal and infant health care. Datasets related to maternal and child health in North Carolina that will be analyzed include Medicaid claims data, birth certificate files, fetal death certificate files, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) data, local public health department staffing and facilities reports, a recent survey of local health department maternity care coordination and child services coordination, and the Area Resource File. In studying care coordination services for pregnant women and infants, this project specifically addresses Maternal and Child Health Bureau Strategic Research Issue #I: Public health service systems and infrastructures at the community, State and/or national levels, as they apply to different maternal and child health populations based on demographic, epidemiological, and/or other factors. In studying differences in the effectiveness of services by race/ethnicity and rural/urban residence, this project also addresses Maternal and Child Health Bureau Strategic Research Issue #II: MCH services and systems of care efforts to eliminate health disparities and barriers to health care access for MCH populations. Successful completion of the project specific aims will result in: 1) improved knowledge about the overall effectiveness of care coordination services for mothers and children; 2) improved knowledge about differential access to care coordination and its effectiveness across subgroups of women and children; and in the longterm: 3) improved organization and delivery of maternal and child care coordination services; and 4) improved health outcomes for mothers and their children as a result of increased care coordination service effectiveness.Publications
Listed is descending order by year published.
Hillemeier MM, Domino ME, Wells R, et al. Does maternity care coordination influence perinatal health care utilization? Evidence from North Carolina. Health Serv Res. Epub ahead of print 2017 July 20.
Shepherd-Banigan M, Domino ME, Wells R, Rutledge R, Hillemeier MM, Van Houtven CH. Do maternity care coordination services encourage use of behavioral health treatment among pregnant women on Medicaid? Women's Health Issues. 2017;27(4):449-455.
Rutledge RI, Domino ME, Hillemeier MM, Wells R. The effect of maternity care coordination services on utilization of postpartum contraceptive services. Contraception. 2016;94(5):541-547.
Cilenti D, Kum HC, Wells R, Whitmire JT, Goyal RK, Hillemeier MM. Changes in North Carolina maternal health service use and outcomes among Medicaid-enrolled pregnant women during state budget cuts. J Public Health Manag Pract. 2015;21(2):208-213.
Hillemeier MM, Domino ME, Wells R, et al. Effects of maternity care coordination on pregnancy outcomes: propensity-weighted analyses. Matern Child Health J. 2015;19(1):121-127.
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