Prevalence and Predictors of Integrated Care Among Teen Mothers and Their Infants.
Prevalence and Predictors of Integrated Care Among Teen Mothers and Their Infants.
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DOI：
10.1016/j.jadohealth.2022.04.018
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发表时间：
2022-10
影响因子：
7.6
通讯作者：
Gregory, Emily F
中科院分区：
文献类型：
--
作者：
Larsen, Alexandra L;Lorch, Scott A;Passarella, Molly;Gregory, Emily F
综合模式的初级保健为父母的青少年，其中青少年和婴儿照顾同一个临床团队在同一天，与减少重复怀孕和增加避孕和免疫接种的吸收。我们的目的是确定青少年婴儿二对组合接受综合护理的频率。这项研究使用Medicaid Analytic eXtract数据创建了一个回顾性队列，其中12-17岁的母亲与2007-2012年在12个州出生的婴儿有关。十几岁的婴儿在出生后的一年里都参加了医疗补助计划。主要结局是出生后一年内的综合护理，定义为≥ 1例青少年和婴儿在同一天就诊，由同一名临床医生标识符付费。Logistic回归分析评估了综合护理与产妇人口统计学、二孩健康、临床医生专业和社区因素之间的关系。在20，203对夫妇中，3，371人（16.7%）在出生后一年内接受了综合护理。接受综合治疗的二人组平均接受1.2次（SD 1.3）综合访视。综合护理的二人组有更多的访问（14.9，SD 10.6对11.7，SD 8.3），包括更多的预防性访问的青少年和青少年和婴儿的急性访问。在回归分析中，综合护理与孕产妇因素（年龄较小，非拉丁白色种族，孕产妇健康风险），居住在农村或高度贫困地区，以及曾经访问过家庭医学临床医生。虽然不常见，但综合护理与更多地参与医疗保健有关。实施综合护理可以支持增加对养育子女的青少年的预防性护理。
Integrated models of primary care for parenting teens, in which teens and infants are cared for by the same clinical team on the same day, are associated with reduced repeat pregnancies and increased uptake of contraception and immunization. Our purpose was to determine how frequently teen-infant dyads receive integrated care. This study used Medicaid Analytic eXtract data to create a retrospective cohort of mothers aged 12–17 linked with infants born from 2007–2012 in 12 states. Teen-infant dyads were enrolled in Medicaid throughout the year after birth. The primary outcome was integrated care in the year after birth, defined as ≥ 1 instance when teen and infant had visits on the same day, billed to the same clinician identifier. Logistic regression assessed the relationship between integrated care and maternal demographics, dyad health, clinician specialty, and community factors. Of 20,203 dyads, 3,371 (16.7%) had integrated care in the year after birth. Dyads with integrated care had a mean of 1.2 (SD 1.3) integrated visits. Dyads with integrated care had more visits (14.9, SD 10.6 vs. 11.7, SD 8.3), including more preventive visits for teens and more acute visits for both teens and infants. In regression, integrated care was associated with maternal factors (younger age, non-Latinx white race, maternal health risks), residence in rural or high-poverty areas, and ever visiting Family Medicine clinicians. Though uncommon, integrated care was associated with greater engagement in health care. Implementation of integrated care may support increased preventive care for parenting teens.