RT Journal Article
SR Electronic
T1 Influence of Provider Characteristics and Insurance Status on Maternal Serum Alpha-Fetoprotein Screening
JF The Journal of the American Board of Family
                Practice
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 357
OP 365
DO 10.3122/15572625-11-5-357
VO 11
IS 5
A1 Laura D. Jenkins-Woelk
A1 Laura-Mae Baldwin
A1 Tina R. Raine
A1 L. Gary Hart
A1 Meredith A. Fordyce
A1 Roger A. Rosenblatt
YR 1998
UL http://www.jabfm.org/content/11/5/357.abstract
AB Background: The maternal serum alpha-fetoprotein test (MSAFP) was developed to screen for neural tube defects. Little is known about the adoption of the MSAFP test. This study examines the effect of provider specialty and geographic location and patient insurance status on MSAFP test use in Washington State. Methods: We conducted a retrospective cohort study of MSAFP use in low-risk obstetric patients of five provider groups. MSAFP use was examined for Medicaid and privately insured patients, as well as for the patients of the five provider types. Results: Patients of urban and rural obstetrician-gynecologists were most likely to have MSAFP testing (80.4 percent and 77.0 percent, respectively); patients of urban certified nurse midwives and rural family physicians were least likely to have MSAFP testing (64.2 percent and 62.2 percent, respectively). Patients of certified nurse midwives were more likely to decline MSAFP testing when offered (26.1 percent). Medicaid-insured women were significantly less likely to have MSAFP testing than privately insured women (60.5 percent versus 79.1 percent, P≤0.05). Conclusions: Providers and patients did not uniformly use MSAFP screening. Efforts should be made to ensure that all patients are adequately informed of screening tests for neural tube defects.