HEALTH SERVICES UTILIZATION

QUALITY OF WOMEN'S HEALTH CARE

Indicators of the quality of health care can provide important information about the effectiveness, safety, timeliness, and patient-centeredness of women’s health services.

Indicators used to monitor women’s health care in managed care plans include the timeliness of prenatal care, receipt of postpartum checkups after delivery, screening for chlamydia, screening for cervical cancer, and receipt of mammograms. The accessibility of most of these services is increasing in commercial, Medicare, Medicaid managed care plans.

Perinatal services—prenatal care and postpartum checkups—appear to be more accessible in commercial (private) plans than in public-sector plans financed by Medicaid. The same is true of cervical cancer screening, which is received at least once every 3 years by nearly 82 percent of commercially-insured women and 64 percent of women covered by Medicaid.

In 2003, the rate of breast cancer screening (mammograms) for women aged 52-69 was approximately equal for women in private plans and those covered through Medicare. However, Medicaid-enrolled women in this age group are considerably less likely to receive a mammogram at least once every 2 years.

Chlamydia screening is the one screening service that is more common among Medicaid-enrolled women than those with private coverage: 46 percent of Medicaid-enrolled women aged 21-25 had a chlamydia screen in the previous year, compared to 29 percent of commercially-insured women.

Graph: HEDIS Rates of Cervical Cancer and Chlamydia Screening[d]

Graph: HEDIS Measures of Perinatal Care[d]

Graph: HEDIS Rates of Mammograms[d]