Use of perinatal and infant health services by Mexican-American Medicaid enrollees

P. Moore and J. T. Hepworth
Arizona State University College of Nursing, Tempe 85287-2602.

OBJECTIVES--Lack of health insurance and a regular source of medical care are barriers affecting use of health services by Mexican Americans. We studied perinatal and infant health service use by Mexican-American women and non-Hispanic white women and their infants enrolled in Arizona's Medicaid program and explored characteristics associated with use of health services. DESIGN--A descriptive comparative study that used data collected from office records, birth certificates, and household interviews. SETTING--Participants resided in the state's most populous county and were enrolled in the Arizona Health Care Cost Containment System, a health maintenance organization-oriented Medicaid demonstration project. SUBJECTS--Random sample of 308 Mexican-American mother-infant dyads and 312 non-Hispanic white mother-infant dyads. The women were enrolled before the sixth month of pregnancy and for 60 days post partum; their infants were continuously enrolled throughout their first year. OUTCOME MEASURES--Timing and number of prenatal visits and a modified Kessner Index, postpartum visits, number and purpose of office visits during the infants' first year, and immunizations received. RESULTS--Mexican Americans averaged fewer prenatal visits than non-Hispanic whites (8.6 vs 10.2 visits) and were less likely to have "adequate" care (41.1% vs 52.8%). Both groups of mothers are well below the 68% of women nationally who receive adequate prenatal care. Controlling for important socioeconomic status and cultural characteristics, ethnicity had a strong independent effect on the number of prenatal visits and adequacy of prenatal care. Mexican-American infants made fewer visits (8.2 vs 9.8) and completed fewer age-appropriate immunizations than non-Hispanic whites. CONCLUSIONS--Health insurance and a regular source of care are insufficient conditions for ensuring adequate use of maternal and child health services by Mexican-American Medicaid enrollees. Factors associated with their less frequent use of these preventive health services include higher numbers of children, transportation problems, and less assistance from their support system.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Screening Performance of the Postpartum Depression Screening Scale--Spanish Version
Beck and Gable
J Transcult Nurs 2005;16:331-338.
ABSTRACT  

Newborn Early Discharge Revisited: Are California Newborns Receiving Recommended Postnatal Services?
Galbraith et al.
Pediatrics 2003;111:364-371.
ABSTRACT | FULL TEXT  

Effect of Compliance With Health Supervision Guidelines Among US Infants on Emergency Department Visits
Hakim and Ronsaville
Arch Pediatr Adolesc Med 2002;156:1015-1020.
ABSTRACT | FULL TEXT  

Mexican-Origin Mothers' Experiences Using Children's Health Care Services
Clark
West J Nurs Res 2002;24:159-179.
ABSTRACT  

Effectiveness of Compliance With Pediatric Preventive Care Guidelines Among Medicaid Beneficiaries
Hakim and Bye
Pediatrics 2001;108:90-97.
ABSTRACT | FULL TEXT  

Racial and Ethnic Differences in Access to Medical Care
Mayberry et al.
Med Care Res Rev 2000;57:108-145.
ABSTRACT  

Barriers to Timely Prenatal Care Among Women With Insurance: The Importance of Prepregnancy Factors
BRAVEMAN et al.
Obstet Gynecol 2000;95:874-880.
ABSTRACT | FULL TEXT  

Access Barriers to Health Care for Latino Children
Flores et al.
Arch Pediatr Adolesc Med 1998;152:1119-1125.
ABSTRACT | FULL TEXT