OBJECTIVE: Psychosocial services for low-income pregnant women vary widely in practice, and validated indicators of effective performance are lacking. The study presented here aims to determine whether a measure of provider compliance with a psychosocial service delivery guideline is associated with improved birth outcomes and therefore meets an important validity criterion of a performance indicator. METHODS: Data on psychosocial services delivered to 3467 pregnant women came from 27 sites certified by the California Department of Health Services to provide enhanced perinatal services to Medicaid-eligible women. Multivariate regression analyses were used to test the association of adequate service delivery according to a performance guideline with birth outcomes and the dependence of the association on the credentials of the provider and the type of practice setting. RESULTS: Women who received at least one psychosocial assessment each trimester of care according to the guideline were half as likely as women with inadequate services to have a low birthweight (OR = 0.49; CI 0.34, 0.71) or preterm birth (OR = 0.53; CI 0.40, 0.72) outcome. The effect did not depend on the credentials of the provider or the practice setting type. CONCLUSIONS: The indicator of the adequacy of psychosocial services according to a performance guideline appears to meet a fundamental criterion for a performance indicator, an association with improved outcomes. This indicator may be useful in monitoring performance of enhanced perinatal services for continuous quality improvement of services to low-income pregnant women.
OBJECTIVE:Psychosocial services for low-income pregnant women vary widely in practice, and validated indicators of effective performance are lacking. The study presented here aims to determine whether a measure of provider compliance with a psychosocial service delivery guideline is associated with improved birth outcomes and therefore meets an important validity criterion of a performance indicator. METHODS: Data on psychosocial services delivered to 3467 pregnant women came from 27 sites certified by the California Department of Health Services to provide enhanced perinatal services to Medicaid-eligible women. Multivariate regression analyses were used to test the association of adequate service delivery according to a performance guideline with birth outcomes and the dependence of the association on the credentials of the provider and the type of practice setting. RESULTS:Women who received at least one psychosocial assessment each trimester of care according to the guideline were half as likely as women with inadequate services to have a low birthweight (OR = 0.49; CI 0.34, 0.71) or preterm birth (OR = 0.53; CI 0.40, 0.72) outcome. The effect did not depend on the credentials of the provider or the practice setting type. CONCLUSIONS: The indicator of the adequacy of psychosocial services according to a performance guideline appears to meet a fundamental criterion for a performance indicator, an association with improved outcomes. This indicator may be useful in monitoring performance of enhanced perinatal services for continuous quality improvement of services to low-income pregnant women.
Authors: L M Baldwin; E H Larson; F A Connell; D Nordlund; K C Cain; M L Cawthon; P Byrns; R A Rosenblatt Journal: Am J Public Health Date: 1998-11 Impact factor: 9.308
Authors: Lee Anne Roman; Cristian I Meghea; Jennifer E Raffo; H Lynette Biery; Shelby Berkowitz Chartkoff; Qi Zhu; Susan M Moran; Wm Thomas Summerfelt Journal: Matern Child Health J Date: 2008-12-16
Authors: Winnie O Willis; Clara H Eder; Suzanne P Lindsay; Gilberto Chavez; Shirley T Shelton Journal: J Natl Med Assoc Date: 2004-03 Impact factor: 1.798
Authors: Maureen I Heaman; Wendy A Sword; Noori Akhtar-Danesh; Amanda Bradford; Suzanne Tough; Patricia A Janssen; David C Young; Dawn A Kingston; Eileen K Hutton; Michael E Helewa Journal: BMC Pregnancy Childbirth Date: 2014-06-03 Impact factor: 3.007