Article Figures & Data
Figures
- Figure 1.
Decision tree for analysis of costs of care for teens starting pregnancy in a particular month. The solid square indicates the patient's decision of when to initiate prenatal care, circles indicate probabilities, and open rectangles indicate the utility (in this instance, the cost of care). Month “N” indicates a reiteration of the decision model for each month that prenatal care was begun or for no prenatal care.
- Figure 2.
The cost of prenatal care based on the time of prenatal care initiation for teens.
- Figure 3.
The estimated cost savings for all women (diamonds), whites (triangles), and African-American (squares) women based on the effectiveness of a hypothetical intervention aimed at all pregnant teens who had not received prenatal care by 6 months.
Tables
Care Begun (mo) Prenatal Care Services Used Month 1–4 Prenatal visit once a month until 7th month; then 2 visits per month for months 7 and 8 and 4 visits during month 9
Two screening ultrasounds
Maternal screening for neural tube defects and Down syndrome
Screening for gestational diabetes
Screening for group B streptococcus
Month 5–6 Prenatal visit once a month until 7th month; then 2 visits per month for months 7 and 8 and 4 visits during month 9
One screening ultrasound
Screening for gestational diabetes
Screening for group B streptococcus
Month 7–9 2 prenatal visits per month for months 7 and 8 and 4 visits during month 9
One screening ultrasound
Screening for group B streptococcus
No care No prenatal care or screening tests
Service Cost* (dollars) Source Prenatal care visit 28.87 Medicaid payment schedule in 2006 Level I ultrasound 69.80 Medicaid payment schedule in 2006 4-component neural tube/Down screening 68.94 Medicaid payment schedule in 2006 Maternal diabetes screening 6.32 Medicaid payment schedule in 2006 Group B streptococcus culture 10.23 Medicaid payment schedule in 2006 Routine vaginal delivery (physician reimbursement) 1200.00 Medicaid payment schedule in 2006 Routine vaginal delivery (hospital reimbursement) 2142.91 Mean hospital reimbursement for vaginal delivery without complication in 2006 Cesarean delivery 1200.00 Medicaid payment schedule in 2006 Cesarean delivery (hospital reimbursement) 4450.14 Mean hospital reimbursement for cesarean delivery without complication in 2006 Normal-birth weight infant† 3168.99 From Henderson,10 adjusted to 2006 dollars LBW infant† 28,887.10 From Henderson,10 adjusted to 2006 dollars * Costs expressed as average cost expected to state Medicaid program in 2006 dollars.
† Represents average cost of first year of life.
LBW, low birth weight.
- Table 3.
Rates of Low-Birth Weight and Cesarean Delivery for Teens Based on Month of Prenatal Care Initiation
Prenatal Care Began (mo) LBW Rates (%) Cesarean Section Rates (%) All Women Whites African-Americans All Women Whites Africa-American NBW LBW NBW LBW NBW LBW 1 or 2 9.9 8.4 14.9 19.9 34 19.4 34.8 21.9 32.9 3 9.4 8.0 13.9 18.9 32.5 18.2 33.1 21.5 31.3 4–6 9.3 7.9 13.0 18.1 30.1 17.4 31.2 20.6 29.3 7–9 7.9 6.6 11.6 17.0 24.6 16.6 24.0 19.0 25.5 None 21.5 18.4 30.0 13.8 22.4 14.3 23.0 13.9 21.4 LBW, low birth weight; NBW, normal birth weight.
- Table 4.
Incremental Cost Savings for Pregnant Teens Dependent on the Month Prenatal Care Was Begun*
Prenatal Care Began (mo) All Women Whites African-Americans 1 or 2 2274 2051 3047 3 2457 2137 3390 4–6 2580 2258 3735 7–9 3146 2450 4321 None 0 0 0 * All figures represent the average net savings (dollars) compared to the cost for women receiving no prenatal care.
