Table 3. Rates and Confidence Intervals for Selected Measures of Care for Medicaid/Uninsured Women and Women With Private Insurance: California, 1989-91.
| Measure | Statistical Adjustment | Before Medicaid Expansion 1988-89 | After Medicaid Expansion 1990-91 | Difference in Risk3 | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
|
|
|
|
|||||||||
| Medicaid/Uninsured Rate | Private Rate | Difference in Risk1 | Medicaid/Uninsured Rate | Private Rate | Difference in Risk2 | Rate | 95-Percent Confidence Interval | ||||
|
|
|
||||||||||
| Rate | Confidence Interval | Rate | Confidence Interval | ||||||||
| Initiation of Care During the First Trimester | Raw | 62.8 | 79.5 | -16.78 | -17.20, -16.36 | 64.2 | 81.5 | -17.26 | -17.47, -17.05 | -0.48 | -0.95, -0.01 |
| Adjusted | 64.8 | 79.5 | -14.76 | -15.16, -14.36 | 64.2 | 81.5 | -17.26 | -17.47, -17.05 | -2.50 | -2.95, -2.05 | |
| Initiation of Care Before the Third Trimester | Raw | 89.1 | 96.0 | -6.90 | -7.17, -6.64 | 91.0 | 97.0 | -5.99 | -6.11, -5.87 | 0.91 | 0.62, 1.21 |
| Adjusted | 89.9 | 96.0 | -6.07 | -6.33, -5.82 | 91.0 | 97.0 | -5.99 | -6.11, -5.87 | 0.08 | -0.20, 0.37 | |
| Low Birthweight | Raw | 5.7 | 4.5 | 1.15 | 0.94, 1.34 | 5.1 | 4.3 | 0.81 | 0.71, 0.91 | -0.34 | -0.58, -0.10 |
| Adjusted | 5.5 | 4.5 | 1.01 | 0.81, 1.22 | 5.1 | 4.3 | 0.81 | 0.71, 0.91 | -0.20 | -0.43, 0.02 | |
| IUGR/Prematurity | Raw | 6.0 | 5.2 | 0.75 | 0.50, 1.01 | 5.4 | 5.0 | 0.44 | 0.32, 0.57 | -0.31 | -0.59, -0.03 |
| Adjusted | 5.9 | 5.2 | 0.67 | 0.43, 0.90 | 5.4 | 5.0 | 0.44 | 0.32, 0.57 | -0.23 | -0.49, 0.04 | |
| Baby's LOS Greater than Mother's LOS | Raw | 9.7 | 6.9 | 2.78 | 2.48, 3.08 | 9.0 | 6.8 | 2.18 | 2.03, 2.33 | -0.60 | -0.93, -0.26 |
| Adjusted | 9.4 | 6.9 | 2.47 | 2.18, 2.75 | 9.0 | 6.8 | 2.18 | 2.03, 2.33 | -0.29 | -0.61, 0.03 | |
| Mother's LOS Greater than Baby's LOS | Raw | 2.1 | 1.5 | 0.61 | 0.47, 0.76 | 1.9 | 1.4 | 0.51 | 0.44, 0.58 | -0.11 | -0.27, 0.05 |
| Adjusted | 2.0 | 1.5 | 0.55 | 0.41, 0.68 | 1.9 | 1.4 | 0.51 | 0.44, 0.58 | -0.04 | -0.19, 0.11 | |
| Cesarean Section | Raw | 20.7 | 24.3 | -3.60 | -4.02, -3.19 | 20.6 | 23.5 | -2.92 | -3.13, -2.72 | 0.68 | 0.22, 1.14 |
| Adjusted | 21.1 | 24.3 | -3.17 | -3.56, -2.79 | 20.6 | 23.5 | -2.92 | -3.13, -2.72 | 0.25 | -0.19, 0.68 | |
1
Medicaid/uninsured compared with private insurance, 1989.
2
Medicaid/uninsured compared with private insurance, 1990-91.
3
Medicaid/uninsured compared with private insurance, 1989 to 1990-91.
NOTES: Both raw and adjusted analyses are directly standardized to post-expansion population characteristics to account for temporal changes in mother's age, race, level of education, and marital status. Adjusted analyses are weighted to adjust for decline in the proportion of persons with private insurance during the study years. LOS is length of stay. IUGR is intrauterine growth retardation.
SOURCE: Epstein, A.M., and Newhouse, J.P., Harvard School of Public Health, Harvard Medical School, and Kennedy School of Government, Boston, 1998.