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Meghea, C. I., You, Z., Raffo, J., Leach, R. E., & Roman, L. A. (2015). Statewide Medicaid enhanced prenatal care programs and infant mortality. Pediatrics, 136(2), 334–342.

Manuscript screening details
Screening decision Screening conclusion HomVEE procedures and standards version
Passes screens Eligible for review Version 1
Study design details
Rating Design Attrition Baseline equivalence Compromised randomization Confounding factors Valid, reliable measure(s)
Moderate Non-experimental comparison group design Not applicable Established on race/ethnicity and SES; outcome(s) not feasible to assess at baseline None None Not assessed in manuscripts reviewed before 2021
Notes:
Study characteristics
Study participants The study population included 126,880 women who were recipients of Medicaid and delivered a baby during the 2009-2012 calendar years in Michigan, with 63,440 women each in the treatment and comparison groups. The study sample was, on average, 24.5 years old. Twenty-six percent of the women were married. About 57 percent of women in the research sample were white, 36 percent were black, less than 1 percent were American Indian, and 6 percent were another race or ethnicity. More than 26 percent of women in the research sample were living at less than 33 percent of the federal poverty level, and 55 percent were receiving Medicaid before their pregnancy.
Setting The study took place throughout the state of Michigan.
Intervention services MIHP provides prenatal and postnatal home visiting to pregnant women and infants living in Michigan who are Medicaid beneficiaries. Participation is voluntary, and includes health risk screenings, care coordination, referrals to other services, and interventions that are tailored to the needs of each person. These interventions may address healthy pregnancies, positive birth outcomes, infant safety, and infant health and development.
Comparison conditions Women in the comparison condition received Medicaid during the study period but did not volunteer to participate in any MIHP services.
Subgroups examined This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report).
Subgroups are not listed for manuscripts reviewed before 2021.
Staff characteristics and training Registered nurses and licensed social workers provided services in both clinic and home settings. No additional information was provided about training.
Funding sources The study was funded in part by the Michigan Department of Community Health.
Author affiliation None of the study authors are developers of this model. The authors indicated they have no financial relationships or conflicts of interest.
Peer reviewed Peer reviewed status is not listed for manuscripts reviewed before 2021.
Study Registration:

Clinicaltrials.gov Identifier: None found. Study registration was assessed by HomVEE beginning with the 2014 review.

Findings details

Child health
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Moderate

Infant death < 1 year

FavorableUnfavorable or ambiguousNo Effect
Full sample; Michigan Medicaid 2009-2012 birth cohort One year following birth 126,880 infants Unadjusted proportion = 0.01 Unadjusted proportion = 0.01 OR = 0.73 HomeVEE calculated = -0.19 Statistically significant, p < 0.01

Program and comparison group proportions are less than 0.010. HomVEE calculated the effect size based on the study-reported odds ratio.

Moderate Infant death < 28 days
FavorableUnfavorable or ambiguousNo Effect
Full sample; Michigan Medicaid 2009-2012 birth cohort 28 days following birth 126,880 infants Unadjusted proportion = 0.00 Unadjusted proportion = 0.00 OR = 0.70 HomeVEE calculated = -0.22 Statistically significant, p < 0.01

Program and comparison group proportions are less than 0.005. HomVEE calculated the effect size based on the study-reported odds ratio.

Moderate Infant death 28-365 days
FavorableUnfavorable or ambiguousNo Effect
Full sample; Michigan Medicaid 2009-2012 birth cohort One year following birth 126,880 infants Unadjusted proportion = 0.00 Unadjusted proportion = 0.00 OR = 0.78 HomeVEE calculated = -0.15 Statistically significant, p = 0.02

Program and comparison group proportions are less than 0.005. HomVEE calculated the effect size based on the study-reported odds ratio.

Outcome measure summary

Child health
Outcome measure Description of measure Data collection method Properties of measure
Infant death < 28 days

Neonatal infant death (less than 28 days)

Death certificate

Not applicable

Infant death <1 year

Infant death in the first year of life Death certificate

Not applicable

Infant death 28-365 days

Post-neonatal infant death (28-365 days)

Death certificate

Not applicable