Prenatal Care Coordination and Well-Child Visit Receipt in Early Childhood

Abstract

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 to 2015) and Medicaid claims and enrollment data (2010 to 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) were measured during each year from age 0 up to 4 years old. Conventional logistic regressions and sibling fixed effects (FE) regressions estimated associations 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). In addition, 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 2 years of life. Findings underscore the potential for obstetric care coordination programs to enhance the continuity of preventive care for participating families.

Keywords: Care Coordination; Child Health; Logistic Models; Medicaid; Pediatrics; Pregnancy; Prenatal Care; Well-Child Visits; Wisconsin.