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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >Impact of Medicaid expansion in Oregon on access to prenatal care
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Impact of Medicaid expansion in Oregon on access to prenatal care

机译：医疗补助扩张在俄勒冈州的影响对产前护理的影响

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Medicaid expansion under the Patient Protection and Affordable Care Act (ACA) has the potential to improve reproductive health by allowing low-income women access to healthcare before and early in pregnancy. The aim of this study was to examine the effects of Oregon's Medicaid expansion on timely and adequate prenatal care. We included live births in Oregon from 2012 to 2015 and used individually-linked birth certificate and Medicaid eligibility data. Outcomes were receipt of first trimester prenatal care and receipt of adequate prenatal care. We also assessed Medicaid enrollment one month prior to pregnancy. We estimated the overall effect of Medicaid expansion on prenatal care utilization using probit regression models. Additionally, we assessed the impact of Medicaid expansion on prenatal care utilization via pre-pregnancy Medicaid enrollment using bivariate probit models. Overall, receipt of first trimester prenatal care increased post-expansion by 1.5 percentage points (p < 0.01) after expansion. Receipt of adequate prenatal care also increased significantly post-expansion with an incremental increase of 2.8 percentage points (p < 0.001). Pre-pregnancy Medicaid enrollment increased following Medicaid expansion (beta = 0.55, p < 0.001) and was associated with both timely (beta = 0.48, p < 0.001) and adequate receipt of prenatal care (beta = 0.14, p < 0.001). Using two years of post-ACA data we found that Medicaid expansion had significant positive associations with Medicaid enrollment prior to pregnancy, which subsequently increased receipt of timely and adequate prenatal care. Our study provides evidence that expanding Medicaid has positive effects on women's use of healthcare.
机译：根据《患者保护和平价医疗法案》（ACA）扩大医疗补助计划，通过允许低收入妇女在怀孕前和怀孕早期获得医疗保健，有可能改善生殖健康。这项研究的目的是检验俄勒冈州医疗补助扩大对及时和充分产前护理的影响。我们纳入了俄勒冈州2012年至2015年的活产婴儿，并使用了与出生证明和医疗补助资格相关的个人数据。结果是接受了孕早期产前护理和充分的产前护理。我们还评估了怀孕前一个月的医疗补助登记情况。我们使用probit回归模型估计了医疗补助扩大对产前护理利用的总体影响。此外，我们使用双变量probit模型通过孕前医疗补助登记评估了医疗补助扩大对产前护理利用的影响。总的来说，扩张后接受早期孕期产前护理的人数增加了1.5个百分点（p<0.01）。扩张后接受充分产前护理的人数也显著增加，增加了2.8个百分点（p<0.001）。随着医疗补助扩大（β=0.55，p<0.001），孕前医疗补助登记增加，并且与及时（β=0.48，p<0.001）和充分接受产前护理（β=0.14，p<0.001）相关。使用ACA后两年的数据，我们发现医疗补助的扩大与怀孕前的医疗补助登记有显著的正相关，从而增加了及时和充分产前护理的接收。我们的研究提供了证据，证明扩大医疗补助对女性使用医疗保健有积极影响。

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