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Influence of Provider Characteristics and Insurance Status on Maternal Serum Alpha-Fetoprotein Screening
- Source :
- The Journal of the American Board of Family Medicine. 11:357-365
- Publication Year :
- 1998
- Publisher :
- American Board of Family Medicine (ABFM), 1998.
-
Abstract
- Background: The maternal serum alpha-fetoprotein test (MSAFP) was developed to screen for neural tube defects. Little is known about the adoption of the MSAFP test. This study examines the effect of provider specialty and geographic location and patient insurance status on MSAFP test use in Washington State. Methods: We conducted a retrospective cohort study of MSAFP use in low-risk obstetric patients of five provider groups. MSAFP use was examined for Medicaid and privately insured patients, as well as for the patients of the five provider types. Results: Patients of urban and rural obstetrician-gynecologists were most likely to have MSAFP testing (80.4 percent and 77.0 percent, respectively); patients of urban certified nurse midwives and rural family physicians were least likely to have MSAFP testing (64.2 percent and 62.2 percent, respectively). Patients of certified nurse midwives were more likely to decline MSAFP testing when offered (26.1 percent). Medicaid-insured women were significantly less likely to have MSAFP testing than privately insured women (60.5 percent versus 79.1 percent, P≤0.05). Conclusions: Providers and patients did not uniformly use MSAFP screening. Efforts should be made to ensure that all patients are adequately informed of screening tests for neural tube defects.
- Subjects :
- Male
Washington
medicine.medical_specialty
Screening test
Specialty
Serum alpha-fetoprotein
Pregnancy
medicine
Humans
Mass Screening
Insurance, Physician Services
Neural Tube Defects
Practice Patterns, Physicians'
Test use
Retrospective Studies
Gynecology
Medicaid
Obstetrics
business.industry
Public Health, Environmental and Occupational Health
Prenatal Care
Retrospective cohort study
Middle Aged
United States
Pregnancy Complications
Insurance status
Nurse-Midwives
Female
alpha-Fetoproteins
Family Practice
business
Subjects
Details
- ISSN :
- 15587118 and 15572625
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- The Journal of the American Board of Family Medicine
- Accession number :
- edsair.doi.dedup.....43329f88d7ac16380481640875eb0d51