Teen-Focused Care Versus Adult-Focused Care for the High-Risk Pregnant Adolescent: An Outcomes Evaluation
- 1 November 2001
- journal article
- research article
- Published by Wiley in Public Health Nursing
- Vol. 18 (6), 424-435
- https://doi.org/10.1046/j.1525-1446.2001.00424.x
Abstract
The purpose of this retrospective, matched-case comparison study was to compare outcomes and cost-effectiveness of comprehensive, interdisciplinary teen-centered prenatal care clinics (Young Women's Clinic & Teen Pregnancy and Parenting Clinic) with "traditional" adult-centered obstetric services (University of Washington Medical Center & Group Health Cooperative) in a university medical center and a staff-model HMO. The sample (n = 106) included 27 index teens from Young Women's Clinic and matched cases from the other three clinics, matched on nine risk variables. Findings showed that teen-clinic clients missed fewer appointments (0.96 vs. 2.29, p < 0.05), were more likely to be enrolled in the supplemental Medicaid program First Steps (p < 0.001) and WIC (p < 0.01), were more likely to have vaginal deliveries (90% vs. 75%, p < 0.05) and higher birth weight infants (3330 vs. 3084 g, p < 0.05), and were more likely to attend 2-week (p < 0.001) and 6-week postpartum exams (p < 0.05). Postpartum data were missing for the majority of adult-clinic subjects; teen-clinic postpartum outcomes included high contraception rates (87.5%), breastfeeding (62%), school return postpartum (63%), and long-term follow-up. Costs were lower for teen clinics based on outcomes; cost savings related to preterm labor were similar.Keywords
This publication has 21 references indexed in Scilit:
- Factors Affecting the Decision to Seek Health Care: The Voice of AdolescentsPEDIATRICS, 1997
- Population Management in an HMO: New Roles for NursingPublic Health Nursing, 1995
- Rebuilding nests of survival: a comparative analysis of the needs of at-risk adolescent women and adolescent mothers in the US, Latin America, Asia and AfricaChildhood, 1994
- Prevalence of physical and sexual assault in pregnant adolescentsJournal of Adolescent Health, 1992
- Process, Costs, and Outcomes of Community-Based Prenatal Care for AdolescentsMedical Care, 1991
- The effect of source of prenatal care on care-seeking behavior and pregnancy outcomes among adolescentsJournal of Adolescent Health, 1991
- Maternal age, sociodemographics, prenatal health and behavior: Influences on neonatal risk statusJournal of Adolescent Health Care, 1990
- Unmarried mothers as a high-risk group for adverse pregnancy outcomesJournal of Community Health, 1990
- Birth weight outcomes in a teenage pregnancy case management projectJournal of Adolescent Health Care, 1989
- Teen pregnancy service An interdisciplinary health care delivery system utilizing certified nurse-midwivesJournal of Nurse-Midwifery, 1986