THE IMPACT OF HOME VISITS ON ENROLLMENT PATTERNS IN PREGNANCY-RELATED SERVICES AMONG LOW-INCOME WOMEN

Medicaid now reimburses for care-coordination services for pregnant women in about half of the states. This care-coordination project targeted low-income pregnant women in two Indianapolis neighborhoods that historically have had high black-infant mortality rates. The service provided home visits by teams of workers including registered nurses, social workers, and indigenous community health workers. This retrospective descriptive study evaluated the impact of the home visits on enrollment in pregnancy-related services. Data were collected from the care-coordination records of 381 participants who delivered infants between July 1, 1990, and January 1, 1992. The proportion of participants enrolled in prenatal care, the Special Supplemental Food Program for Women, Infants and Children (WIC), Medicaid, and Food Stamps increased significantly following admission to care coordination. The majority of participants who enrolled in prenatal care and WIC, after admission to care coordination, did so within one month of admission. Home visits were effective in stimulating enrollment in pregnancy-related services. Further studies need to be done to evaluate the impact of home visits on pregnancy outcomes as well as their cost-effectiveness.