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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.

Suggested Citation

  • Theodore Joyce, 1997. "Impact of Augmented Prenatal Care on Birth Outcomes of Medicaid Recipients in New York City," NBER Working Papers 6029, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:6029
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    1. 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.
    2. 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 617-629, October.
    3. Janet Currie & Jonathan Gruber, 1994. "Saving Babies: The Efficacy and Cost of Recent Expansions of Medicaid Eligibility for Pregnant Women," NBER Working Papers 4644, National Bureau of Economic Research, Inc.
    4. 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.
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    Cited by:

    1. 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.
    2. 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.
    3. 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.
    4. Wolfgang Frimmel & Gerald J. Pruckner, 2014. "Birth Weight And Family Status Revisited: Evidence From Austrian Register Data," Health Economics, John Wiley & Sons, Ltd., vol. 23(4), pages 426-445, April.
    5. Sankar Mukhopadhyay & Jeanne Wendel, 2008. "Are prenatal care resources distributed efficiently across high-risk and low-risk mothers?," International Journal of Health Economics and Management, Springer, vol. 8(3), pages 163-179, September.
    6. 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.
    7. Hope Corman & Dhaval M. Dave & Nancy E. Reichman, 2017. "Evolution of the Infant Health Production Function," NBER Working Papers 24131, National Bureau of Economic Research, Inc.
    8. Ellen Meara, 2001. "Why is Health Related to Socioeconomic Status?," NBER Working Papers 8231, National Bureau of Economic Research, Inc.
    9. 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.
    10. repec:pri:crcwel:wp98-30-kaestner is not listed on IDEAS
    11. Fung, Winnie & Robles, Omar, 2016. "Effects of antenatal testing laws on infant mortality," Journal of Health Economics, Elsevier, vol. 45(C), pages 77-90.
    12. Kasey Buckles & Joseph Price, 2013. "Selection and the Marriage Premium for Infant Health," Demography, Springer;Population Association of America (PAA), vol. 50(4), pages 1315-1339, August.
    13. repec:ebl:ecbull:v:9:y:2008:i:22:p:1-14 is not listed on IDEAS
    14. Ayllón, Sara & Ferreira-Batista, Natalia N., 2015. "‘Mommy, I miss daddy’. The effect of family structure on children's health in Brazil," Economics & Human Biology, Elsevier, vol. 19(C), pages 75-89.
    15. Kronborg, Hanne & Sievertsen, Hans Henrik & Wüst, Miriam, 2016. "Care around birth, infant and mother health and maternal health investments – Evidence from a nurse strike," Social Science & Medicine, Elsevier, vol. 150(C), pages 201-211.
    16. 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.
    17. 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.
    18. 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," NBER Working Papers 12004, National Bureau of Economic Research, Inc.
    19. Thomas Buchmueller & John C. Ham & Lara D. Shore-Sheppard, 2015. "The Medicaid Program," NBER Chapters,in: Economics of Means-Tested Transfer Programs in the United States, volume 1, pages 21-136 National Bureau of Economic Research, Inc.
    20. 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.
    21. 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.
    22. 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.

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    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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