ABSTRACT
This study was conducted to examine the potential effects of expanded Medicaid coverage
for low income women. Statewide birth data for 1983 to 1985 were examined to determine
the relationship between prenatal care and admissions to neonatal intensive care units
(NICUs) and the costs of this care. An NICU sample was constituted from infants who
were discharged live following more than 7 NICU days, were referred to an out of state
tertiary center, or died following NICU admission. Inadequate care (no prenatal care,
only last trimester care, or less than five visits) was received by 11 % of the total
birth cohort and by 18% of the infants in the NICU sample (p <0.001). Infants with
inadequate care had a NICU admission rate of 5.10% versus 2.86% for those with adequate
prenatal care (p <0.001). The hospital billings for infants in the NICU sample with
inadequate care were significantly higher than were those for infants with adequate
care (p <0.05). Assuming that economic resources limit access to prenatal care, the
projection can be made that had all women with inadequate prenatal care received Medicaid-covered
adequate prenatal care, expenditure for this care would yield more than a two to one
return in savings in NICU costs.
