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Impact of Augmented Prenatal Care on Birth Outcomes of Medicaid Recipients in New York City

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  • Theodore Joyce

Abstract

I examine whether New York State's Prenatal Care Assistance Program (PCAP) is associated with greater use of prenatal services and improved birth outcomes. PCAP is New York State's augmented prenatal care initiative that became a part of the Medicaid program after expansion in income eligibility thresholds in January, 1990. Data are from the linkage of Medicaid administrative files with New York City birth certificates (N=23,243). For women on cash assistance, I find PCAP is associated with a 20 percent increase in the likelihood of enrollment in WIC, an increase in mean birth weight of 35 grams and a 1.3 percentage point drop in the rate of low birth weight. Associations between PCAP and improved birth outcomes for women on medical assistance are similar, but appear contaminated by selection bias. Reductions in newborn costs associated with PCAP participation are modest, between $100-$300 dollars per recipient, and are insufficient to offset program expenditures.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 6029.

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Date of creation: May 1997
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Publication status: published as Journal of Health Economics, Vol. 18, no. 1 (January 1999): 31-67
Handle: RePEc:nbr:nberwo:6029

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  1. Murphy, Kevin M & Topel, Robert H, 1985. "Estimation and Inference in Two-Step Econometric Models," Journal of Business & Economic Statistics, American Statistical Association, vol. 3(4), pages 370-79, October.
  2. Theodore Joyce & Andrew D. Racine & Sandra McCalla & Hassan Wehbeh, 1994. "The Impact of Prenatal Exposure to Cocaine on Newborn Costs and Length of Stay," NBER Working Papers 4673, National Bureau of Economic Research, Inc.
  3. Joyce, Theodore, 1999. "Impact of augmented prenatal care on birth outcomes of Medicaid recipients in New York City," Journal of Health Economics, Elsevier, vol. 18(1), pages 31-67, January.
  4. Robert A. Moffitt, 1996. "Selection Bias Adjustment in Treatment-Effect Models as a Method of Aggregation," NBER Technical Working Papers 0187, National Bureau of Economic Research, Inc.
  5. J.D. Angrist & Guido W. Imbens & D.B. Rubin, 1993. "Identification of Causal Effects Using Instrumental Variables," NBER Technical Working Papers 0136, National Bureau of Economic Research, Inc.
  6. Barbara Devaney & Linda Bilheimer & Jennifer Schore, 1992. "Medicaid costs and birth outcomes: The effects of prenatal WIC participation and the use of prenatal care," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 11(4), pages 573-592.
  7. Reichman, Nancy E. & Florio, Maryanne J., 1996. "The effects of enriched prenatal care services on Medicaid birth outcomes in New Jersey," Journal of Health Economics, Elsevier, vol. 15(4), pages 455-476, August.
  8. Kaestner, Robert & Joyce, Theodore & Wehbeh, Hassan, 1996. "The Effect of Maternal Drug Use on Birth Weight: Measurement Error in Binary Variables," Economic Inquiry, Western Economic Association International, vol. 34(4), pages 617-29, October.
  9. Gruber, J. & Currie, J., 1994. "Saving Babies: The Efficacy and Cost of Recent Expansions of Medicaid Eligibility for Pregnant Women," Working papers 94-11, Massachusetts Institute of Technology (MIT), Department of Economics.
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Citations

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Cited by:
  1. Lefebvre, Pierre, 2006. "Le gradient santé / revenu familial des nouveau-nés québécois de 1998 après quatre ans : faible ou inexistant?," L'Actualité Economique, Société Canadienne de Science Economique, vol. 82(4), pages 523-595, décembre.
  2. Nastis, Stefanos A. & Crocker, Thomas D., 2012. "Valuing mother and child health: The intrauterine environment," Economics & Human Biology, Elsevier, vol. 10(3), pages 318-328.
  3. Ted Joyce & Diane Gibson & Silvie Colman, 2004. "The Changing Association Between Prenatal Participation in WIC and Birth Outcomes in New York City," NBER Working Papers 10796, National Bureau of Economic Research, Inc.
  4. repec:ebl:ecbull:v:9:y:2008:i:22:p:1-14 is not listed on IDEAS
  5. Robert Kaestner & Nancy Reichman & Theodore Joyce, 1998. "Effect of Insurance on Infant Health: A Case Study of Low-Income Women in New Jersey," Working Papers 988, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Research on Child Wellbeing..
  6. Jason Abrevaya, 2006. "Estimating the effect of smoking on birth outcomes using a matched panel data approach," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 21(4), pages 489-519.
  7. Kasey S. Buckles, 2012. "Selection and the Marriage Premium for Infant Health," Working Papers 003, University of Notre Dame, Department of Economics, revised Jul 2012.
  8. Joyce, Theodore, 1999. "Impact of augmented prenatal care on birth outcomes of Medicaid recipients in New York City," Journal of Health Economics, Elsevier, vol. 18(1), pages 31-67, January.
  9. Ellen Meara, 2001. "Why is Health Related to Socioeconomic Status?," NBER Working Papers 8231, National Bureau of Economic Research, Inc.
  10. Conway, Karen Smith & Deb, Partha, 2005. "Is prenatal care really ineffective? Or, is the 'devil' in the distribution?," Journal of Health Economics, Elsevier, vol. 24(3), pages 489-513, May.
  11. Karen Smith Conway & Andrea Kutinova, 2006. "Maternal health: does prenatal care make a difference?," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 461-488.
  12. Wolfgang Frimmel & Gerald J. Pruckner, 2011. "Birth weight and family status revisited: evidence from Austrian register data," Economics working papers 2011-17, Department of Economics, Johannes Kepler University Linz, Austria.
  13. Sankar Mukhopadhyay & Wei Yang & Wai Lee & Jeanne Wendel, 2008. "Analyzing the impact of prenatal care on infant health: do we have useful input and output measures?," Economics Bulletin, AccessEcon, vol. 9(22), pages 1-14.
  14. Gray, Bradley, 2001. "Do Medicaid physician fees for prenatal services affect birth outcomes?," Journal of Health Economics, Elsevier, vol. 20(4), pages 571-590, July.
  15. Dhaval M. Dave & Sandra Decker & Robert Kaestner & Kosali I. Simon, 2008. "Re-examining the Effects of Medicaid Expansions for Pregnant Women," NBER Working Papers 14591, National Bureau of Economic Research, Inc.
  16. Nancy E. Reichman & Hope Corman & Kelly Noonan & Dhaval Dave, 2006. "Typically Unobserved Variables (TUVs) and Selection into Prenatal Inputs: Implications for Estimating Infant Health Production Functions," Working Papers 930, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Migration and Development..
  17. Sankar Mukhopadhyay & Jeanne Wendel, 2008. "Are prenatal care resources distributed efficiently across high-risk and low-risk mothers?," International Journal of Health Care Finance and Economics, Springer, vol. 8(3), pages 163-179, September.

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