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Teen‐Focused Care Versus Adult‐Focused Care for the High‐Risk Pregnant Adolescent: An Outcomes Evaluation
Author(s) -
BensussenWalls Wendy,
Saewyc Elizabeth M.
Publication year - 2001
Publication title -
public health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 55
eISSN - 1525-1446
pISSN - 0737-1209
DOI - 10.1046/j.1525-1446.2001.00424.x
Subject(s) - medicine , breastfeeding , medicaid , pregnancy , prenatal care , family medicine , postpartum period , public health , pediatrics , obstetrics , health care , population , nursing , environmental health , biology , economics , genetics , economic growth
The purpose of this retrospective, matched‐case comparison study was to compare outcomes and cost‐effectiveness of comprehensive, interdisciplinary teen‐centered prenatal care clinics (Young Women's Clinic & Teen Pregnancy and Parenting Clinic) with “traditional” adult‐centered obstetric services (University of Washington Medical Center & Group Health Cooperative) in a university medical center and a staff‐model HMO. The sample ( n = 106) included 27 index teens from Young Women's Clinic and matched cases from the other three clinics, matched on nine risk variables. Findings showed that teen‐clinic clients missed fewer appointments (0.96 vs. 2.29, p < 0.05), were more likely to be enrolled in the supplemental Medicaid program First Steps ( p < 0.001) and WIC ( p < 0.01), were more likely to have vaginal deliveries (90% vs. 75%, p < 0.05) and higher birth weight infants (3330 vs. 3084 g, p < 0.05), and were more likely to attend 2‐week ( p < 0.001) and 6‐week postpartum exams ( p < 0.05). Postpartum data were missing for the majority of adult‐clinic subjects; teen‐clinic postpartum outcomes included high contraception rates (87.5%), breastfeeding (62%), school return postpartum (63%), and long‐term follow‐up. Costs were lower for teen clinics based on outcomes; cost savings related to preterm labor were similar.