Limited success has been achieved in identifying high-risk pregnant women via prenatal risk identification tools. The purposes of this study were to examine a risk assessment and nursing telephonic case management protocol used to identify high-risk mothers and infants, and to evaluate the costs and benefits of the protocol. This study involved a retrospective review of insurance data held by a large managed care organization (MCO). Analyzed data included information about current and past medical problems, and current lifestyle risk factors. Data analysis included frequencies, χ2, t tests, and logistic regression analysis. Pregnant MCO members experienced fewer high-risk conditions versus nonmembers. The overall pregnancy cost for a member was $1,818 versus $4,587 for a nonmember. Members experienced 2.5 times fewer babies hospitalized in the NICU, and significantly fewer mothers with high-risk conditions. The MCO program reduces costs and promotes better maternal and infant outcomes.
Marianne H. Hutti, DNS, WHNP-C, is professor and coordinator of the Women's Health Nurse Practitioner Program at the University of Louisville. She currently practices 1 day per week as a nurse practitioner, and is an active researcher with current NIH funding. In addition, she has received numerous local and national teaching awards.
Wayne M. Usui, PHD, is professor and chairman, Sociology Department, at the University of Louisville. Utilizing funding from the US Department of Education, he is investigating school reform, educational dynamics, and achievement in Kentucky schools, and is the project director for a NSF grant, investigating “Metropolitan Reform: From Government to Governance.”
Address correspondence to Marianne H. Hutti, DNS, WHNP-C, University of Louisville School of Nursing, Louisville, KY 40292 (firstname.lastname@example.org).
This study was funded by a research grant from the Eli Lilly Foundation.