Abstract
The problem of physicians dropping the practice of obstetrics is becoming more serious each year in the United States. Those who remain in practice are increasingly reluctant to serve women who receive Medicaid assistance. Previous research has tended to focus on low reimbursement and liability as barriers that physicians perceive to providing prenatal care to low-income clients. In a 1992 survey in rural Idaho, however, physicians who have been serving these clients for at least 4 years rated other factors equally or more important in treating low-income women. These other factors, discussed in this paper, have to do with the administrative and psychosocial support coordinated by public health nurses for their internal clients, the physicians, as well as for their external clients, pregnant women.
Full text
PDF




Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Buescher P. A., Roth M. S., Williams D., Goforth C. M. An evaluation of the impact of maternity care coordination on Medicaid birth outcomes in North Carolina. Am J Public Health. 1991 Dec;81(12):1625–1629. doi: 10.2105/ajph.81.12.1625. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hadley J. Physician participation in Medicaid: evidence from California. Health Serv Res. 1979 Winter;14(4):266–280. [PMC free article] [PubMed] [Google Scholar]
- Mitchell J. B., Schurman R. Access to private obstetrics/gynecology services under Medicaid. Med Care. 1984 Nov;22(11):1026–1037. doi: 10.1097/00005650-198411000-00005. [DOI] [PubMed] [Google Scholar]
- Nesbitt T. S., Connell F. A., Hart L. G., Rosenblatt R. A. Access to obstetric care in rural areas: effect on birth outcomes. Am J Public Health. 1990 Jul;80(7):814–818. doi: 10.2105/ajph.80.7.814. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schleuning D., Rice G., Rosenblatt R. A. Addressing barriers to perinatal care: a case study of the Access to Maternity Care Committee in Washington State. Public Health Rep. 1991 Jan-Feb;106(1):47–52. [PMC free article] [PubMed] [Google Scholar]
- Sloan F., Mitchell J., Cromwell J. Physician participation in state Medicaid programs. J Hum Resour. 1978;13 (Suppl):211–245. [PubMed] [Google Scholar]
- Taylor D. H., Jr, Ricketts T. C., 3rd, Berman J. L., Kolimaga J. T. One state's response to the malpractice insurance crisis: North Carolina's Rural Obstetrical Care Incentive Program. Public Health Rep. 1992 Sep-Oct;107(5):523–529. [PMC free article] [PubMed] [Google Scholar]
