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Implementation and early effects of medicaid policy interventions to promote racial equity in pregnancy and early childhood outcomes in Pennsylvania: protocol for a mixed methods study.
Jarlenski, Marian; Cole, Evan; McClure, Christine; Sanders, Sarah; Smalls, Marquita; Méndez, Dara D.
Afiliación
  • Jarlenski M; Department of Health Policy and Management, University of Pittsburgh School of Public Health, 130 DeSoto St, A619, 15261, Pittsburgh, PA, USA. marian.jarlenski@pitt.edu.
  • Cole E; Department of Health Policy and Management, University of Pittsburgh School of Public Health, 130 DeSoto St, A619, 15261, Pittsburgh, PA, USA.
  • McClure C; Department of Health Policy and Management, University of Pittsburgh School of Public Health, 130 DeSoto St, A619, 15261, Pittsburgh, PA, USA.
  • Sanders S; Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
  • Smalls M; Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
  • Méndez DD; Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
BMC Health Serv Res ; 24(1): 498, 2024 Apr 22.
Article en En | MEDLINE | ID: mdl-38649983
ABSTRACT

BACKGROUND:

There are large racial inequities in pregnancy and early childhood health within state Medicaid programs in the United States. To date, few Medicaid policy interventions have explicitly focused on improving health in Black populations. Pennsylvania Medicaid has adopted two policy interventions to incentivize racial health equity in managed care (equity payment program) and obstetric service delivery (equity focused obstetric bundle). Our research team will conduct a mixed-methods study to investigate the implementation and early effects of these two policy interventions on pregnancy and infant health equity.

METHODS:

Qualitative interviews will be conducted with Medicaid managed care administrators and obstetric and pediatric providers, and focus groups will be conducted among Medicaid beneficiaries. Quantitative data on healthcare utilization, healthcare quality, and health outcomes among pregnant and parenting people will be extracted from administrative Medicaid healthcare data. Primary outcomes are stakeholder perspectives on policy intervention implementation (qualitative) and timely prenatal care, pregnancy and birth outcomes, and well-child visits (quantitative). Template analysis methods will be applied to qualitative data. Quantitative analyses will use an interrupted time series design to examine changes over time in outcomes among Black people, relative to people of other races, before and after adoption of the Pennsylvania Medicaid equity-focused policy interventions.

DISCUSSION:

Findings from this study are expected to advance knowledge about how Medicaid programs can best implement policy interventions to promote racial equity in pregnancy and early childhood health.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Medicaid / Equidad en Salud / Disparidades en Atención de Salud Límite: Female / Humans / Infant / Pregnancy País/Región como asunto: America do norte Idioma: En Revista: BMC Health Serv Res Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Medicaid / Equidad en Salud / Disparidades en Atención de Salud Límite: Female / Humans / Infant / Pregnancy País/Región como asunto: America do norte Idioma: En Revista: BMC Health Serv Res Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido