ORIGINAL RESEARCH
David C. Mallinson, PhD
Corresponding Author: David C. Mallinson, PhD; Department of Family and Preventive Medicine, Rush Medical College, Rush University
Email: david_mallinson@rush.edu
DOI: 10.3122/jabfm.2024.240302R2
Keywords: Care Coordination, Child Health, Logistic Models, Medicaid, Pediatrics, Pregnancy, Prenatal Care, Wisconsin
Dates: Submitted: 08-14-2024; Revised: 11-19-2024; 01-16-2025; Accepted: 01-21-2025
Status: In production for ahead of print.
INTRODUCTION: This study evaluates participation in Wisconsin Medicaid’s Prenatal Care Coordination (PNCC) program and its association with children’s well-child visit (WCV) receipt.
STUDY DESIGN: Data came from linked Wisconsin birth records (2011-2015) and Medicaid claims and enrollment data (2010-2019). The sample comprised 113,347 children with Medicaid-paid births and continuous Medicaid enrollment ranging from 12 to 48 months post-birth. A sibling subsample comprised of 35,373 children. PNCC receipt in pregnancy was measured dichotomously (none; any) and categorically (none; assessment/care plan only; service uptake). Any WCV receipt and recommended WCV receipt (which varied by age) was measured during each year from age 0 up to 4 years-old. Conventional logistic regressions and sibling fixed effects (FE) regressions estimated association between PNCC receipt and WCV receipt.
RESULTS: Demographic-adjusted sibling FE regressions—which best control for unobserved confounding—indicated that any PNCC was positively associated with children receiving any WCVs at age 0 to <1 year-old (OR 1.48; 95% CI 1.05-2.08) and at age 1 to <2 years-old (OR 1.24; 95% CI 1.03-1.50). Additionally, adjusted sibling FE regressions found that PNCC service uptake was associated with children receiving the recommended number of WCVs at age 0 to <1 year-old (OR 1.35; 95% CI 1.18-1.55).
CONCLUSIONS: PNCC may improve children’s WCV attendance in the first two years of life. Findings underscore the potential for obstetric care coordination programs to enhance the continuity of preventive care for participating families.