TY - JOUR
T1 - Prenatal care in Oregon and Washington
T2 - Policy and utilization for vulnerable women
AU - Docherty, Angie
AU - Johnston, Alison L.
N1 - Publisher Copyright:
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2015/3/25
Y1 - 2015/3/25
N2 - Background: In the prenatal period, women can have sustained contact with nurses and other clinicians, forming relationships that are likely to be health enhancing for both the woman and her unborn child. Yet, first trimester care use in Oregon dropped noticeably over the past decade. In comparison with Washington state, Oregon has not shown substantial recovery. Objective: The aim of this study was to explore potential reasons for the declining prenatal trend in Oregon. Methods: We collated county-level birth data from all Oregon and Washington counties from 2000 to 2010. A descriptive, observational, time-series regression analysis for both states assessed the influence of maternal determinants known to impact first trimester care utilization. Results: In Oregon, two factors were significantly associated with declining first trimester care: Medicaid funding (p < .01) and maternal Hispanic ethnicity (p = .02). In Washington, there was no significant association between any assessed determinant and first trimester care. Discussion: In Oregon, over the period of our study, women dependent on Medicaid and women of Hispanic origin were less likely to utilize first trimester care. A similar trend for these variables was not observed in Washington. At the time of our study, both states had different policy approaches, which may explain some of the observable patterns. Amid current healthcare reforms and rising immigration, our findings suggest the need for strong advocacy for those less able to access or utilize care.
AB - Background: In the prenatal period, women can have sustained contact with nurses and other clinicians, forming relationships that are likely to be health enhancing for both the woman and her unborn child. Yet, first trimester care use in Oregon dropped noticeably over the past decade. In comparison with Washington state, Oregon has not shown substantial recovery. Objective: The aim of this study was to explore potential reasons for the declining prenatal trend in Oregon. Methods: We collated county-level birth data from all Oregon and Washington counties from 2000 to 2010. A descriptive, observational, time-series regression analysis for both states assessed the influence of maternal determinants known to impact first trimester care utilization. Results: In Oregon, two factors were significantly associated with declining first trimester care: Medicaid funding (p < .01) and maternal Hispanic ethnicity (p = .02). In Washington, there was no significant association between any assessed determinant and first trimester care. Discussion: In Oregon, over the period of our study, women dependent on Medicaid and women of Hispanic origin were less likely to utilize first trimester care. A similar trend for these variables was not observed in Washington. At the time of our study, both states had different policy approaches, which may explain some of the observable patterns. Amid current healthcare reforms and rising immigration, our findings suggest the need for strong advocacy for those less able to access or utilize care.
KW - Medicaid
KW - ethnicity
KW - first trimester
KW - healthcare disparity
KW - prenatal care
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U2 - 10.1097/NNR.0000000000000073
DO - 10.1097/NNR.0000000000000073
M3 - Article
C2 - 25738623
AN - SCOPUS:84925602386
SN - 0029-6562
VL - 64
SP - 117
EP - 127
JO - Nursing research
JF - Nursing research
IS - 2
ER -