PolicyLab

This project addresses the lack of coordination between adult care and pediatrics by identifying preventive care opportunities from the mother-infant dyad perspective in the year after birth. Prioritizing at-risk populations, our study specifically looks at outcomes for women treated for depression, anxiety, obesity, diabetes or hypertension during pregnancy or in the first three months postpartum, and women who had a preterm birth. Children whose parents experience these conditions are more likely to develop the conditions themselves, emphasizing the importance of medical services for these new parents and families.

For the purposes of this analysis, we considered any care billed to the child’s health insurance as pediatric care and any care billed to the mother’s insurance as adult care. During the first part of the study, primary outcomes included looking at the number of preventive visits in the first year after birth including postpartum care, contraception or generalized attention to women’s health risk. Using Medicaid data from almost 600,000 mother-infant pairs, our results showed more preventative visits occurred in pediatric care than adult settings. This signals that while children are receiving preventive care, mothers may be forgoing their own—in fact, 38% of mother-infant pairs did not receive any preventive care in adult settings. Our research also showed those included in the cardiovascular and mental health risk group were more likely to receive adult preventative care than mothers who had a preterm birth or pairs in which mothers had no risk factors.